[Intravenous vancomycin treatment in children; its clinical usefulness and serum concentration monitoring].
Fourteen pediatric patients with infections (21 episodes) were treated with intravenous vancomycin (VCM) and the clinical efficacy and side effects were evaluated. The ages of the patients ranged from 1 month to 13 years and their body weights from 1.9 to 49 kg. The drug was administered by intravenous drip infusion for 60 minutes. Doses given were 10 (except one with 20) mg/kg every 6 (8 or 12 in patients with renal dysfunction) hours for 5 to 27 days. A leukemic patient was given the drug for 3.5 months. Those episodes which responded well to the VCM treatment included 10 episodes in 8 children with methicillin-resistant Staphylococcus aureus infections, 4 in 2 children with methicillin-resistant Staphylococcus epidermidis (MRSE) infections and 2 in 2 children with methicillin-susceptible S. aureus infections. Those infections included sepsis, empyema, bronchitis, subcutaneous abscess, cellulitis and lymphadenitis. Clinical effects were fair in 1 patient with gingival abscess due to MRSE, and undetermined in 4 patients with infections of which etiologies were unknown. The drug was well tolerated, although rash, which disappeared after more prolonged infusion, was noted in 2 episodes and elevated serum concentrations of transaminases occurred in 4 episodes (both side effects occurred in 1 patient given 20 mg/kg every 6 hours). The minimal inhibitory concentrations of VCM against isolated staphylococci were 0.5-1 microgram/ml. Monitoring for serum concentrations of drug was performed in 10 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Pediatrics, Asahikawa Medical College.
K
K
Fujita
K
K
Murono
M
M
Yoshikawa
K
K
Miyamoto
D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000097:blood / Q000188:drug therapy*; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood*
D014640:Vancomycin