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Research Letter
June 10, 2019

Defining Target Vancomycin Trough Concentrations for Treating Staphylococcus aureus Infection in Infants Aged 0 to 90 Days

Author Affiliations
  • 1Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
  • 2Department of General Medicine, The Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
  • 3Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  • 4Department of Pharmacology, The University of Melbourne, Parkville, Victoria, Australia
  • 5Department of Infectious Diseases, Sydney Children’s Hospital, Randwick, New South Wales, Australia
  • 6School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
  • 7Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia
  • 8Department of Neonatal Medicine, The Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
  • 9School of Pharmacy, University of Otago, Dunedin, Otago, New Zealand
JAMA Pediatr. Published online June 10, 2019. doi:10.1001/jamapediatrics.2019.1488

Target trough concentrations for vancomycin hydrochloride therapy in infants younger than 90 days are poorly defined. In adults, the pharmacodynamic target for Staphylococcus aureus correlates with the ratio of the area under the concentration-time curve over a 24-hour period (AUC24) to the minimum inhibitory concentration (MIC) of the bacteria exceeding 400 (ie, AUC24/MIC>400).1,2 There are no widely available AUC calculators that we know of for use in infants younger than 90 days to enable clinicians to determine the AUC24 at steady state (approximately 48 hours) based on a trough concentration. We developed a population-based pharmacokinetic model to determine the association between serum trough vancomycin concentrations and AUC24.

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