TITLE

Vancomycin dosage in overweight and obese children

AUTHOR(S)
MILLER, MISTY; MILLER, JAMIE L.; HAGEMANN, TRACY M.; HARRISON, DONALD; CHAVEZ-BUENO, SUSANA; JOHNSON, PETER N.
PUB. DATE
November 2011
SOURCE
American Journal of Health-System Pharmacy;11/1/2011, Vol. 68 Issue 21, p2062
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose. Vancomycin dosages in overweight and obese children were evaluated. Methods. This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 µg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 µg/mL) and independent variables. Results. Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037). Conclusion. A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 µg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 µg/mL.
ACCESSION #
66908076

 

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