Initial vancomycin dosing in pediatric oncology and stem cell transplant patients.

Publication/Presentation Date

1-1-2009

Abstract

BACKGROUND: Gram-positive bacteremia is a common infection in pediatric oncology and stem cell transplant (SCT) patients requiring therapy with vancomycin. Optimal dosing of vancomycin in this patient population has not been well established.

METHODS: All pediatric oncology and SCT patients receiving vancomycin between October 2006 and March 2007 were included in this study. Therapeutic levels were defined as levels between 10 and 15 mg/dL and low therapeutic levels were between 5 and 9 mg/dL. Information regarding any recent or concurrent nephrotoxic medications was collected.

RESULTS: Fifty-six patients received 82 courses of vancomycin during the study period. More patients (53.7%) received vancomycin for empiric therapy and 78% had recent or concurrent use of nephrotoxic medications. Using standardized vancomycin dosing guided by a computerized provider order entry system, there were significantly more patients who were in the subtherapeutic range than the supratherapeutic range (P=0.0023). There were also significantly more patients in the low therapeutic than the therapeutic range (P

CONCLUSIONS: Pediatric oncology and SCT patients with normal renal function require higher daily vancomycin doses than other pediatric patients.

Volume

31

Issue

1

First Page

3

Last Page

7

ISSN

1536-3678

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

19125078

Department(s)

Department of Pediatrics

Document Type

Article

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