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February 1986

Vancomycin Pharmacokinetics in Small, Seriously Ill Infants

Author Affiliations

From the Department of Pediatrics/Adolescent Medicine, St Louis University School of Medicine (Drs Naqvi and Keenan); and the Pharmacy Department (Mr Reichley) and Infectious Disease Laboratory (Mr Fortune), Cardinal Glennon Children's Hospital, St Louis.

Am J Dis Child. 1986;140(2):107-110. doi:10.1001/archpedi.1986.02140160025021

• Twenty vancomycin pharmacokinetic studies were performed on 17 small infants who were receiving the antibiotic for treatment of documented infections. Fourteen patients were less than or equal to 41 weeks' postconception. In this group there was no statistical difference in mean elimination rate, volume of distribution, or clearance between neonates and infants 4 to 8 weeks of age. However, they had significantly lower clearance and prolonged mean β—half-life than infants who were 3 to 6 months old (>43 weeks' postconception). Vancomycin clearance was directly related to postconceptional age by linear regression analysis. β—Half-life was influenced by the weight of the patient, volume of distribution, and gestational age. In view of the interpatient variability observed in the prematurely born infants, pharmacokinetic studies should be performed to determine the appropriate dose and intervals in vancomycin therapy.

(AJDC 1986;140:107-110.