Study on Initial Dose of Vancomycin Hydrochloride Using Estimated Pharmacokinetic Parameters in Pediatric Patients

Abstract

In 2016, the antimicrobial TDM Guidelines revised edition was published, and a pediatric dose of vancomycin (VCM) was set. However, in actual use, further verification is needed. Therefore, we evaluated the validity of the guidelines for pediatric doses, using the estimated pharmacokinetic parameters of pediatric patients treated with VCM. The median dose of VCM administered was 41.7 mg/kg/day, and the ratio of serum VCM trough concentration that reached 10-15 μg/mL was 10.5% and that above 15 μg/mL was 3.5%. If administered based on the pediatric dose of the guidelines, the ratio of serum VCM trough concentration that reached 10-15 μg/mL was predicted to be 38.6%, suggesting that the pediatric dose of the guidelines was useful, whereas that above 15 μg/mL was estimated to 28%. Therefore, in patients at high risk for renal dysfunction in cases with age 1-12 months or 7-12 years, a regimen with reduced number of doses, but without a change in the daily dose from the pediatric dose of the guidelines, may be useful.