AI Article Synopsis
Article Abstract
Background: Anecdotal experience and studies have shown that most pediatric patients fail to reach target therapeutic vancomycin trough levels (VTLs) and required higher total daily doses (TDD). This retrospective study aims to evaluate the frequency of hospitalized children who achieved target VTLs with a vancomycin (VNCO) dosing regimen of 40-60 mg/kg/d q6h and to assess the VNCO-TDD required to attain the target and their effects on clinical outcomes in pediatric patients.
Methods: After ethical approval, patients of 3 month-12 years were evaluated in this chart review study who received ≥ 3 intravenous-VNCO doses and appropriately drawn blood samples of VTLs between October 2019 to June 2020. Data were retrieved for demographic and clinical characteristics, culture reports, VNCO-regimen, subsequent steady-state VTLs, concomitant nephrotoxic medications, and serum creatinine. Clinical pharmacists made interventions in VNCO therapy and higher VNCO-TDD were used. Safety of higher vs standard daily doses and their clinical impact on duration of therapy, hospital stay, and survival were evaluated.
Results: A total of 89 (39.1%) patients achieved target VTLs (SD-group). The smallest proportion (18.2%) of 2-6 years patients achieved target VTLs and reported the lowest mean value of 10.1 ± 0.2 mg/L which was a significant difference (p < 0.05) from all subgroups. Subtherapeutic VTLs were observed in 139 (60.9%) cases (HD-group), who received higher VNCO-TDD of 72 ± 8.9 mg/kg/d q6h to achieve the targets. Duration of therapy in culture-proven septic patients was significantly (p = 0.025) longer in SD-group [18.4 ± 12.2 days] than HD-group [15.1 ± 8.9 days]. Nephrotoxicity and electrolyte imbalance were comparable in groups. Length of hospital stay was significantly (p = 0.011) longer [median 22 (range 8-55) days] in SD-group compared to HD-group [median 16 (range 8-37) days]. Number of patients survived in HD-group were significantly (p = 0.008) higher than SD-group [129 (92.8%) vs 75 (84.3%)].
Conclusion: Initial Vancomycin doses of 72 ± 8.9 mg/kg/day q6h are required to achieve therapeutic target in 3 months to 12 years patients. High doses are not associated with higher nephrotoxicity than reported with low doses. In addition, efficient pharmacist intervention for the use of higher VNCO-TDD may improve clinical outcomes in terms of duration of therapy, hospital stay, and survival.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392299 | PMC |
| http://dx.doi.org/10.1186/s40360-022-00606-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
JAK2 inactivating mutations promotes endometrial cancer progression by targeting HIF-1α.
Discov Oncol
December 2024
Department of Obstetrics and Gynecology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China.
Objective: Endometrial cancer (EC) is the ninth most common malignancy among women. While mutations in JAK2 are frequently observed in EC, the specific biological functions of JAK2 in endometrial cancer are poorly understood.
Methods: The genetic alterations of JAK2 in different cancer types were explored using sequencing dataset deposited at TCGA database.
In-situ Growth of Metallocluster inside Heterometal-organic Cage to Switch Electron Transfer for Targeted CO2 Photoreduction.
Angew Chem Int Ed Engl
December 2024
Northeast Normal University, Key Laboratory of Polyoxometalate and Reticular Material Chemistry of Ministry of Education, Institute of Functional Material Chemistry, Local United Engineering Lab for Power Battery, CHINA.
Construction of metal-organic cages (MOCs) with internal modifications is a promising avenue to build enzyme-like cavities and unlocking the mystery of highly catalytic activity and selectivity of enzymes. However, current interests are mainly focused on single-metal-node cages, little achievement has been expended to metalloclusters-based architectures, and the in situ endogenous generation of metal clusters. Herein, based on the hard-soft-acids-bases (HSAB), the metalloclusters-based heterometallic MOC (Cu3VMOP) constructed of [Cu3OPz3]+ and [V6O6(OCH3)9(SO4)(CO2)3]2- clusters was obtained by one-pot method.
View Article and Find Full Text PDFOut-of-Pocket Health Expenditure and Associated Factors: Insights From National Health Accounts (NHA) Using Panel Data Analysis.
Inquiry
December 2024
Department of Economics, University of Kashmir, Srinagar, India.
This study investigates the relationship between out-of-pocket (OOP) healthcare spending, economic growth, population growth, and government health expenditure as a proportion of general government expenditure using National Health Accounts (NHA) estimates. Out-of-Pocket (OOP) healthcare spending imposes a substantial financial burden on households, especially in developing economies such as India. Understanding the factors that influence OOP payments is crucial for policymakers seeking to enhance healthcare systems and achieve Universal Health Coverage (UHC).
View Article and Find Full Text PDFUpdates in innovation of the treatment of pyoderma gangrenosum.
Expert Rev Clin Pharmacol
December 2024
Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
Introduction: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers with undermined borders. The management of PG is challenging due to the lack of standardized evidence-based treatments.
Areas Covered: This review examines recent efforts to establish standardized outcomes for clinical trials to facilitate the drug development process for PG.
Direct cardiac reprogramming via combined CRISPRa-mediated endogenous Gata4 activation and exogenous Mef2c and Tbx5 expression.
Mol Ther Nucleic Acids
December 2024
McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Direct cardiac reprogramming of fibroblasts into induced cardiomyocytes (iCMs) can be achieved by ectopic expression of cardiac transcription factors (TFs) via viral vectors. However, risks like genomic mutations, viral toxicity, and immune response limited its clinical application. Transactivation of endogenous TFs emerges as an alternative approach that may partially mitigate some of the risks.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!