دورية أكاديمية
Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients.
| العنوان: | Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients. |
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| المؤلفون: | Silva DC; Intensive Care Unit, Grupo de Apoio ao Adolescente e a Criança com Câncer, Instituto de Oncologia Pediátrica, Universidade Federal de São Paulo, Brazil., Seixas GT, Araujo OR, Arduini RG, Carlesse FA, Petrilli AS |
| المصدر: | The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases [Braz J Infect Dis] 2012 Jul-Aug; Vol. 16 (4), pp. 361-5. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Editora Country of Publication: Brazil NLM ID: 9812937 Publication Model: Print Cited Medium: Internet ISSN: 1678-4391 (Electronic) Linking ISSN: 14138670 NLM ISO Abbreviation: Braz J Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2010- : Rio de Janeiro : Elsevier Editora Original Publication: Salvador, Bahia, Brazil : Contexto, c1997- |
| مواضيع طبية MeSH: | Anti-Bacterial Agents/*blood , Neoplasms/*virology , Staphylococcal Infections/*drug therapy , Staphylococcus/*drug effects , Vancomycin/*blood, Adolescent ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/pharmacokinetics ; Area Under Curve ; Bayes Theorem ; Child ; Child, Preschool ; Critical Care ; Drug Dosage Calculations ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Retrospective Studies ; Vancomycin/administration & dosage ; Vancomycin/pharmacokinetics |
| مستخلص: | Background: Usual treatment regimens with vancomycin often fail to provide adequate serum levels in patients with severe infections. Methods: Retrospective analysis of vancomycin trough serum measurements. The following parameters were calculated by Bayesian analysis: vancomycin clearance, distribution volume, and peak estimated concentrations. The area under the concentration curve (AUC) (total daily dose/24 h clearance of vancomycin) was used to determine the effectiveness of treatment through the ratio of AUC/minimum inhibitory concentration (MIC) above 400, using MIC=1 μg/mL, based on isolates of Staphylococci in cultures. Results: Sixty-one vancomycin trough measurements were analyzed in 31 patients. AUC/MIC>400 was obtained in 34 out of 61 dosages (55.7%), but the mean vancomycin dose required to achieve these levels was 81 mg/kg/day. In cases where the usual doses were administered (40-60 mg/kg/day), AUC/MIC>400 was obtained in nine out of 18 dosages (50%), in 13 patients. Trough serum concentrations above 15 mg/L presented a positive predictive value of 100% and a negative predictive value of 71% for AUC/MIC>400. Conclusion: Higher than usual vancomycin doses may be required to treat staphylococcal infections in children with oncologic/hematologic diseases. Since the best known predictor of efficacy is the AUC/MIC ratio, serum trough concentrations must be analyzed in conjunction with MICs of prevalent Staphylococci and pharmacokinetic tools such as Bayesian analysis. (Copyright © 2012 Elsevier Editora Ltda. All rights reserved.) |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 6Q205EH1VU (Vancomycin) |
| تواريخ الأحداث: | Date Created: 20120801 Date Completed: 20130405 Latest Revision: 20151119 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.bjid.2012.06.011 |
| PMID: | 22846125 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1678-4391 |
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| DOI: | 10.1016/j.bjid.2012.06.011 |