Table 4.
Summary statistics of the predicted AUC and trough concentrations and Monte Carlo simulations for various dosing regimens of vancomycin in VLBW neonates.
| PMA (wks) | Scr (mg/dl) | Dose | AUC0−24 mean (sd) µg.h/ml | Trough mean (sd) µg/ml | AUC0−24 400–600 µg.h/ml | AUC0−24 400–800 µg.h/ml | Trough > 15 µg/ml |
|---|---|---|---|---|---|---|---|
| ≤29 | <0.6 | 15 mg/kg q12h | 440 (107) | 10.5 (3.43) | 53% | 61% | 11% |
| 17.5 mg/kg q12ha | 513 (125) | 12.2 (4) | 62% | 80% | 23% | ||
| 20 mg/kg q12h | 586 (143) | 14 (4.6) | 50% | 84% | 38% | ||
| 0.6–0.9 | 17.5 mg/kg q18h | 451 (116) | 10.2 (3.8) | 55% | 65% | 10% | |
| 20 mg/kg q18h | 515 (133) | 11.6 (4.3) | 58% | 78% | 20% | ||
| 15 mg/kg q12ha | 523 (118) | 13.3 (3.64) | 63% | 84% | 28% | ||
| > 0.9 to1.2 | 15 mg/kg q18h | 450 (108) | 10.8 (3.5) | 56% | 70% | 27% | |
| 17. 5 mg/kg q18ha | 525 (127) | 12.5 (4.1) | 60% | 83% | 27% | ||
| 20 mg/kg q24h | 480 (127) | 10.3 (4.2) | 56% | 70% | 13% | ||
| >29 | <0.6 | 12.5 mg/kg q8h | 452 (115) | 12.5 (1) | 56% | 66% | 26% |
| 20 mg/kg q12h | 494 (131) | 11 (4.3) | 56% | 74% | 17% | ||
| 0.6–0.9 | 15 mg/kg q12h | 453 (106) | 11 (3.4) | 57% | 69% | 12% | |
| 17.5 mg/kg q12ha | 528 (124) | 12.8 (4) | 60% | 82% | 28% | ||
| > 0.9 to1.2 | 17.5 mg/kg q12h | 440 (116) | 9.8 (3.8) | 51% | 63% | 3% | |
| 20 mg/kg q18ha | 503 (133) | 11.2 (4.3) | 76% | 76% | 18% | ||
| 15 mg/kg q12ha | 513 (119) | 12.9 (3.7) | 58% | 83% | 27% |
For all doses, the probability of an AUC0−24 > 800 µg. h/ml and/or trough >20 µg/ml is less than 10%.
a
The selected recommended dose to achieve the therapeutic target of an AUC0-24 of 400–600 µg.h/ml in more than 60% of patients or to achieve the wider range of 400–800 µg.h/ml in more than 80% of patients.