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- Title
Pharmacokinetic Characteristics and Clinical Outcomes of Vancomycin in Young Children With Various Degrees of Renal Function.
- Authors
Zhang, Huanian; Wang, Yang; Gao, Ping; Hu, Jiasheng; Chen, Yujun; Zhang, Long; Shen, Xiantao; Xu, Hua; Xu, Qiong
- Abstract
Although vancomycin pharmacokinetics are affected by age and renal function in adults and older children, its pharmacokinetics in children aged 1 month to 2 years remained unclear. We investigated clinical outcome and nephrotoxicity in younger children with renal insufficiency who were treated with vancomycin. One hundred and ten children aged 1 month to 2 years were enrolled, and they were divided into 3 groups: normal renal function (group A), mild renal insufficiency (group B), and moderate renal insufficiency (group C). A population pharmacokinetic model was established. Significant differences were observed for trough concentration, AUC0-24 h, CL, and t1/2 in the 3 groups. When given at 40 mg/kg per day, 36.4%, 62.5%, and 85.0% of children achieved the target of AUC/MIC ≥ 400, and 47.0%, 70.8%, and 95% of children obtained early good clinical outcomes in groups A, B, and C ( P < .05), respectively. One child in group A and 4 children in group C suffered from acute kidney injury. These results indicated that children with renal insufficiency readily achieved the target AUC/MIC but were at increased risk of nephrotoxicity. Vancomycin clearance and creatinine clearance were not correlated with each other in children with renal insufficiency, indicating that both renal function and serum concentration should be monitored during vancomycin therapy.
- Subjects
NEPHROTOXICOLOGY -- Risk factors; COMPARATIVE studies; CREATININE; KIDNEY function tests; KIDNEY failure; VANCOMYCIN; SEVERITY of illness index; STATISTICAL models; PHARMACODYNAMICS; CHILDREN
- Publication
Journal of Clinical Pharmacology, 2016, Vol 56, Issue 6, p740
- ISSN
0091-2700
- Publication type
Article
- DOI
10.1002/jcph.653