title: Pharmacokinetic Characteristics and Clinical Outcomes of Vancomycin in Young Children With Various Degrees of Renal Function.
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.
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Huanian
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Gao
authors.affiliation: Department of Pediatric Neurology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Jiasheng
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Yujun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of ICU, Wuhan Children's Hospital, Hubei, China.
authors.forename: Long
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Wuhan Children's Hospital, Hubei, China.
authors.forename: Xiantao
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Clinical Pharmacology, Wuhan Children's Hospital, Hubei, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Xu
mesh_terms: D000900:Anti-Bacterial Agents / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology*; D016908:Gram-Positive Bacterial Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D051437:Renal Insufficiency / Q000097:blood* / Q000139:chemically induced / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014640:Vancomycin / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: nephrotoxicity; pediatric; renal insufficiency; vancomycin