| Clinical pharmacokinetics of vancomycin in the neonate: a review. | |
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MedLine Citation:
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PMID: 22892931 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Neonatal sepsis is common and is a major cause of morbidity and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on vancomycin pharmacokinetics in neonates and to provide a critical analysis of the literature. A bibliographic search was performed using PubMed and Embase, and articles with a publication date of August 2011 or earlier were included in the analysis. Vancomycin pharmacokinetic estimates, which are different in neonates compared with adults, also exhibit extensive inter-neonatal variability. In neonates, several vancomycin dosing schedules have been proposed, mainly based on age (i.e., postmenstrual and postnatal), body weight or serum creatinine level. Other covariates [e.g., extracorporeal membrane oxygenation (ECMO), indomethacin or ibuprofen, and growth restriction] of vancomycin pharmacokinetics have been reported in neonates. Finally, vancomycin penetrates cerebrospinal fluid (range = 7-42%). Renal function drives vancomycin pharmacokinetics. Because either age or weight is the most relevant covariate of renal maturation, these covariates should be considered first in neonatal vancomycin dosing guidelines and further adjusted by renal dysfunction indicators (e.g., ECMO and ibuprofen/indomethacin). In addition to the prospective validation of available dosing guidelines, future studies should focus on the relevance of therapeutic drug monitoring and on the value of continuous vancomycin administration in neonates. |
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Authors:
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Gian Maria Pacifici; Karel Allegaert |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinics (São Paulo, Brazil) Volume: 67 ISSN: 1980-5322 ISO Abbreviation: Clinics (Sao Paulo) Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-08-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101244734 Medline TA: Clinics (Sao Paulo) Country: Brazil |
Other Details:
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Languages: eng Pagination: 831-7 Citation Subset: IM |
Affiliation:
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Section of Pharmacology, Department of Neurosciences, Medical School, University of Pisa, Pisa, IT. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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