Evaluation of vancomycin individualized model-based dosing approach in neonates
Background: Vancomycin is commonly used to treat methicillin-resistant staphylococcal infections in neonates. Consensus on its ideal dosing in neonates has not been achieved. Model-based dosing recently has evolved as an important tool to optimize vancomycin initial dosing. The aim of this is to eva...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957222002583 |
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| author | Manal Abouelkheir Abdullah Almohaizeie Abdulrahman Almutairi Sara Almuhisen Saeed Alqahtani Abdullah Alsultan |
| author_facet | Manal Abouelkheir Abdullah Almohaizeie Abdulrahman Almutairi Sara Almuhisen Saeed Alqahtani Abdullah Alsultan |
| author_sort | Manal Abouelkheir |
| collection | DOAJ |
| description | Background: Vancomycin is commonly used to treat methicillin-resistant staphylococcal infections in neonates. Consensus on its ideal dosing in neonates has not been achieved. Model-based dosing recently has evolved as an important tool to optimize vancomycin initial dosing. The aim of this is to evaluate a population pharmacokinetic model-based approach in achieving the vancomycin therapeutic target of an AUC0-24 400 as recommended by the recent IDSA treatment guidelines. This model was implemented as a simple Excel calculator to individualize and optimize vancomycin initial dosing in neonates. Methods: An Excel calculator was developed using a previously published population pharmacokinetic model in neonates. It was evaluated using retrospectively retrieved data. For each patient, the initial empiric dose was calculated using the proposed Excel model and the most widely used neonatal dosing references. The probability of achieving the target AUC0–24 of >400 mg h/L using the model-based method was calculated and compared with that of the empiric doses using other references. Results: This analysis included 225 neonates. The probability of achieving the target AUC0–24 >400 was 89% using our model-based approach compared with 11%–59% using tertiary neonatal dosing references (p < 0.01 for all comparisons). Conclusion: These innovative personalized dosing calculators are promising to improve vancomycin initial dosing in neonates and are easily applicable in routine practices. |
| format | Article |
| id | doaj-art-6bfcbf2799d445e8a78a9ecd675156da |
| institution | Kabale University |
| issn | 1875-9572 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-6bfcbf2799d445e8a78a9ecd675156da2025-08-20T03:33:46ZengElsevierPediatrics and Neonatology1875-95722023-05-0164332733410.1016/j.pedneo.2022.10.006Evaluation of vancomycin individualized model-based dosing approach in neonatesManal Abouelkheir0Abdullah Almohaizeie1Abdulrahman Almutairi2Sara Almuhisen3Saeed Alqahtani4Abdullah Alsultan5Department of Clinical Pharmacy, College of Pharmacy, Misr International University, Cairo, EgyptPharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Department of Pharmaceutical Care, Prince Sultan Military Medical City, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, King Fahad Medical City, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Corresponding author.Background: Vancomycin is commonly used to treat methicillin-resistant staphylococcal infections in neonates. Consensus on its ideal dosing in neonates has not been achieved. Model-based dosing recently has evolved as an important tool to optimize vancomycin initial dosing. The aim of this is to evaluate a population pharmacokinetic model-based approach in achieving the vancomycin therapeutic target of an AUC0-24 400 as recommended by the recent IDSA treatment guidelines. This model was implemented as a simple Excel calculator to individualize and optimize vancomycin initial dosing in neonates. Methods: An Excel calculator was developed using a previously published population pharmacokinetic model in neonates. It was evaluated using retrospectively retrieved data. For each patient, the initial empiric dose was calculated using the proposed Excel model and the most widely used neonatal dosing references. The probability of achieving the target AUC0–24 of >400 mg h/L using the model-based method was calculated and compared with that of the empiric doses using other references. Results: This analysis included 225 neonates. The probability of achieving the target AUC0–24 >400 was 89% using our model-based approach compared with 11%–59% using tertiary neonatal dosing references (p < 0.01 for all comparisons). Conclusion: These innovative personalized dosing calculators are promising to improve vancomycin initial dosing in neonates and are easily applicable in routine practices.http://www.sciencedirect.com/science/article/pii/S1875957222002583PharmacokineticsVancomycinNeonatesPharmacodynamics |
| spellingShingle | Manal Abouelkheir Abdullah Almohaizeie Abdulrahman Almutairi Sara Almuhisen Saeed Alqahtani Abdullah Alsultan Evaluation of vancomycin individualized model-based dosing approach in neonates Pediatrics and Neonatology Pharmacokinetics Vancomycin Neonates Pharmacodynamics |
| title | Evaluation of vancomycin individualized model-based dosing approach in neonates |
| title_full | Evaluation of vancomycin individualized model-based dosing approach in neonates |
| title_fullStr | Evaluation of vancomycin individualized model-based dosing approach in neonates |
| title_full_unstemmed | Evaluation of vancomycin individualized model-based dosing approach in neonates |
| title_short | Evaluation of vancomycin individualized model-based dosing approach in neonates |
| title_sort | evaluation of vancomycin individualized model based dosing approach in neonates |
| topic | Pharmacokinetics Vancomycin Neonates Pharmacodynamics |
| url | http://www.sciencedirect.com/science/article/pii/S1875957222002583 |
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