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- Title
Determining the optimal vancomycin daily dose for pediatrics: a meta-analysis.
- Authors
Silva Alves, Geisa; Silva, Samuel; Frade, Virginia; Rodrigues, Danielle; Baldoni, André; Castro, Whocely; Sanches, Cristina
- Abstract
Objective: The objective of this study was to check which initial dose of vancomycin is needed to achieve the therapeutic target that is currently used in pediatrics. Methods: The search was conducted in the following data sources: Pubmed (1980-2017), the Cochrane Library, and Embase (1986-2017) and the references of the published studies; searches were performed using the key terms: child, children, pediatrics, infants and adolescents, vancomycin, pharmacokinetics, and pharmacodynamics. The data extracted from the studies were analyzed and grouped using RevMan V 5.2 software. The confidence interval (CI) 95% and the odds ratio (OR) were calculated considering the Mantel-Haenszel random effect. Results: From the 704 studies identified, 40 revealed eligibility for this review and only 20 presented enough data to be included in the statistical analysis. The articles found in this review were published between 1980 and 2017. The vancomycin doses varied between 40 mg/kg/day to 120 mg/kg/day. The statistical tests demonstrated significant clinical heterogeneity of I (84%). Conclusions: The meta-analysis study revealed in the majority of studies that doses lower than 60 mg/kg/day were not enough to achieve desirable vancomycin plasma concentrations 'area under the curve in 24 h/minimum inhibitory concentration >400 (AUC/MIC>400) or trough 10-20 mg/L' to control bacterial infections in pediatrics.
- Subjects
BACTERIAL diseases; DRUG therapy; CONFIDENCE intervals; MEDICAL databases; INFORMATION storage &; retrieval systems; MEDICAL information storage &; retrieval systems; MEDLINE; META-analysis; ONLINE information services; VANCOMYCIN; SYSTEMATIC reviews; DATA analysis; DESCRIPTIVE statistics; ODDS ratio; CHILDREN
- Publication
European Journal of Clinical Pharmacology, 2017, Vol 73, Issue 11, p1341
- ISSN
0031-6970
- Publication type
Article
- DOI
10.1007/s00228-017-2306-3