title: Comparison of intermittent versus continuous vancomycin infusion for the treatment of late-onset sepsis in preterm infants.
abstract: BACKGROUND
  Vancomycin a frequently used antimicrobial for the treatment of late-onset neonatal sepsis. It can be infused either intermittently or continuously, however, there is no consensus on the optimal dosing regimen.
  
  
  OBJECTIVE
  To evaluate microbiological outcomes, clinical response and adverse events of vancomycin when administered via continuos intravenous infusion.
  
  
  METHODS
  The files of preterm infants (<34 weeks), who received either intermittent (group I, n = 41) or continuous (group II, n = 36) vancomycin infusion for the treatment of late-onset sepsis, were investigated retrospectively. Clinical and demographic features were recorded.
  
  
  RESULTS
  Clinical improvement rates, Töllner scores and microbiological outcomes did not differ significantly between groups. At 48th hour of vancomycin infusion, 52.8% of infants achieved therapeutic concentrations of vancomycin in group II compared with 34.1% of patients in group I (p = 0.002). Thirty-nine percent of infants in group I had supratherapeutic concentrations of vancomycin at 48th hour compared with 5.6% in group II (p = 0.002). Dose adjustment rate in group I did not differ than group II (65.9% vs. 52.8% respectively, p = 0.3). However, when we subdivide group I into two according to dosing intervals, dose adjustment rates were more common in infants with a gestational age <29 weeks for whom intermittent infusion was performed in 18 hours intervals (92.9% vs 51.9% , p = 0.014).
  
  
  CONCLUSIONS
  In preterm infants, continuous and intermittent infusions of vancomycin have similar clinical efficacies. Continuous infusion is well-tolerated and require less blood sampling compared to intermittent infusion especially in infants less than 29 weeks of gestational age.
authors.affiliation: Zeynep Kamil Maternity and Childrens' Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Demirel
authors.affiliation: Zeynep Kamil Maternity and Childrens' Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: İmamoglu
authors.affiliation: Koc University School of Medicine, Department of Pediatrics, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Gursoy
authors.affiliation: Yakacık Maternity and Childrens' Hospital, Istanbul, Turkey.
authors.forename: U
authors.initials: U
authors.lastname: Demirel
authors.affiliation: Zeynep Kamil Maternity and Childrens' Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Topçuoglu
authors.affiliation: Zeynep Kamil Maternity and Childrens' Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Karatekin
authors.affiliation: Zeynep Kamil Maternity and Childrens' Training and Research Hospital, Neonatal Intensive Care Unit, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Ovali
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D007262:Infusions, Intravenous / Q000295:instrumentation* / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Continuous infusion; intermittent infusion; preterm infants; vancomycin