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  • Title: [Pharmacologic clinical monitoring of serum vancomycin levels in pediatric patients].
    Author: Nandí-Lozano E, Ramírez-López E, Avila-Figueroa C.
    Journal: Rev Invest Clin; 2003; 55(3):276-80. PubMed ID: 14515672.
    Abstract:
    OBJECTIVE: To analyze the results from the clinical monitoring of serum vancomycin levels among pediatric patients receiving this drug. METHODS: Retrospective study of data from routine monitoring of serum vancomycin concentrations. The study population includes children who received vancomycin for more than 3 days and had peak and trough vancomycin serum concentration documented. The vancomycin concentrations were measured by an immunoassay procedure. RESULTS: We obtained 70 vancomycin concentrations from pediatric patients whose ages ranged from newborn to 13 years old. Mean peak and trough concentrations were 45.7 +/- 8.0 and 18.7 +/- 9.6 micrograms/mL, respectively. We used as a reference normal ranges for Cpmax of 25-40 micrograms/mL and Cpmin of 5-40 micrograms/mL. Only 26.1% of the patients were on Cpmax normal ranges, 47.8% were above the range and 26% under the lower limit. In regards to the Cpmin 17% of the cases were between the accepted limits, 41% above the upper limit and 41% under the normal range. CONCLUSION: Our data suggest that less than a fifth of the patients have serum levels on therapeutic range and almost half of these population had serum levels above the normal range. This might be explained by the type of the population sampled, reflecting a selection bias by detecting levels only among patients with an increased risk for toxicity. Finally, we stress the importance of accurately documenting dose, timing, and renal function in the records of all patients subjected to serum vancomycin determinations.
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