Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients

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dc.contributor.author Silva, Dáfne Cardoso Bourguignon da [UNIFESP]
dc.contributor.author Seixas, Gláucia Toribio Finoti [UNIFESP]
dc.contributor.author Araujo, Orlei Ribeiro de [UNIFESP]
dc.contributor.author Arduini, Rodrigo Genaro [UNIFESP]
dc.contributor.author Carlesse, Fabianne Altruda de Moraes Costa [UNIFESP]
dc.contributor.author Petrilli, Antonio Sergio [UNIFESP]
dc.date.accessioned 2015-06-14T13:44:53Z
dc.date.available 2015-06-14T13:44:53Z
dc.date.issued 2012-08-01
dc.identifier http://dx.doi.org/10.1016/j.bjid.2012.06.011
dc.identifier.citation Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 16, n. 4, p. 361-365, 2012.
dc.identifier.issn 1413-8670
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/7249
dc.description.abstract BACKGROUND: Usual treatment regimens with vancomycin often fail to provide adequate serum levels in patients with severe infections. METHODS: Retrospective analysis of vancomycin trough serum measurements. The following parameters were calculated by Bayesian analysis: vancomycin clearance, distribution volume, and peak estimated concentrations. The area under the concentration curve (AUC) (total daily dose/24 h clearance of vancomycin) was used to determine the effectiveness of treatment through the ratio of AUC/minimum inhibitory concentration (MIC) above 400, using MIC = 1 µg/mL, based on isolates of Staphylococci in cultures. RESULTS: Sixty-one vancomycin trough measurements were analyzed in 31 patients. AUC/MIC > 400 was obtained in 34 out of 61 dosages (55.7%), but the mean vancomycin dose required to achieve these levels was 81 mg/kg/day. In cases where the usual doses were administered (40-60 mg/kg/day), AUC/MIC > 400 was obtained in nine out of 18 dosages (50%), in 13 patients. Trough serum concentrations above 15 mg/L presented a positive predictive value of 100% and a negative predictive value of 71% for AUC/MIC > 400. CONCLUSION: Higher than usual vancomycin doses may be required to treat staphylococcal infections in children with oncologic/hematologic diseases. Since the best known predictor of efficacy is the AUC/MIC ratio, serum trough concentrations must be analyzed in conjunction with MICs of prevalent Staphylococci and pharmacokinetic tools such as Bayesian analysis. en
dc.format.extent 361-365
dc.language.iso eng
dc.publisher Brazilian Society of Infectious Diseases
dc.relation.ispartof Brazilian Journal of Infectious Diseases
dc.rights Acesso aberto
dc.subject Immunosuppression en
dc.subject Drug resistance en
dc.subject Microbial en
dc.subject Staphylococcus en
dc.subject Anti-bacterial agents en
dc.subject Pharmacokinetics en
dc.title Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients en
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Universidade Federal de São Paulo (UNIFESP) Grupo de Apoio ao Adolescente e a Criança com Câncer Instituto de Oncologia Pediátrica
dc.description.affiliation UNIFESP GRAACC IOP
dc.description.affiliation Universidade Federal de São Paulo (UNIFESP) Department of Pediatrics
dc.description.affiliationUnifesp UNIFESP, Grupo de Apoio ao Adolescente e a Criança com Câncer Instituto de Oncologia Pediátrica
dc.description.affiliationUnifesp UNIFESP, GRAACC IOP
dc.description.affiliationUnifesp UNIFESP, Department of Pediatrics
dc.identifier.file S1413-86702012000400009.pdf
dc.identifier.scielo S1413-86702012000400009
dc.identifier.doi 10.1016/j.bjid.2012.06.011
dc.description.source SciELO
dc.identifier.wos WOS:000307527400009



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