Table 3.
Overview of efficacy and safety target attainment of vancomycin, gentamicin, and tobramycin in each cohort
| Efficacy | Subtherapeutic | Therapeutic | Supratherapeutic |
|---|---|---|---|
| Vancomycin PICU (total) (n = 62) | 19 (30.6) | 21 (33.9) | 22 (35.5) |
| Vancomycin NICU (total) (n = 102) | 29 (28.4) | 40 (39.2) | 33 (32.4) |
| Preterm GA + < 7 days PNA (n = 17) | 7 (41.2) | 6 (35.3) | 4 (23.5) |
| Preterm GA + ≥ 7 days PNA (n = 65) | 20 (30.8) | 28 (43.1) | 17 (26.2) |
| Term GA + < 7 days PNA (n = 10) | 2 (20.0) | 5 (50.0) | 3 (30.0) |
| Term GA + ≥ 7 days PNA (n = 10) | 0 (0.0) | 1 (10.0) | 9 (90.0) |
| Gentamicin NICU (total) (n = 87)a | 59 (67.8) | 27 (31.0) | 1 (1.1) |
| < 32 weeks GA + < 7 days PNA (n = 36)a | 16 (44.4) | 20 (55.6) | 0 (0.0) |
| < 32 weeks GA + ≥ 7 days PNA (n = 9)a | 9 (100.0) | 0 (0.0) | 0 (0.0) |
| 32–37 weeks GA + < 7 days PNA (n = 9)a | 5 (55.6) | 3 (33.3) | 1 (11.1) |
| 32–37 weeks GA + ≥ 7 days PNA (n = 2) | 2 (100.0) | 0 (0.0) | 0 (0.0) |
| Term GA + any PNA (n = 31)a | 27 (87.1) | 4 (12.9) | 0 (0.0) |
| Safety | – | Safe | Toxic |
|---|---|---|---|
| Gentamicin NICU (total) (n = 95)a | – | 81 (85.3) | 14 (14.7) |
| < 32 weeks GA + < 7 days PNA (n = 38) | – | 38 (100.0) | 0 (0.0) |
| < 32 weeks GA + ≥ 7 days PNA (n = 12) | – | 9 (75.0) | 3 (25.0) |
| 32–37 weeks GA + < 7 days PNA (n = 9)a | – | 8 (88.9) | 1/9 (11.1) |
| 32–37 weeks GA + ≥ 7 days PNA (n = 2) | – | 2 (100.0) | 0 (0.0) |
| Term GA + any PNA (n = 34)a | – | 24 (70.6) | 10 (29.4) |
| Tobramycin NICU (total) (n = 221) | – | 170 (76.9) | 51 (23.1) |
| < 32 weeks GA + < 7 days PNA (n = 46) | – | 45 (97.8) | 1 (2.2) |
| 32–37 weeks GA + < 7 days PNA (n = 28) | – | 24 (85.7) | 4 (14.3) |
| Term GA + any PNA (n = 76) | – | 48 (63.2) | 28 (36.8) |
| Preterm GA + ≥ 7 days PNA (n = 71) | – | 53 (74.6) | 18 (25.4) |
Data are presented as n (%). Target attainment for vancomycin, gentamicin, and tobramycin in the four different cohorts. Therapeutic concentrations were defined as a vancomycin trough concentration of 10–15 mg/L and gentamicin peak concentration of 8–12 mg/L. Safety for gentamicin and tobramycin was defined as trough concentrations ≤ 1 mg/L. Patients with a GA ≥ 37 weeks are categorized as “term” and patients with GA < 37 weeks as “preterm” if no specific GA range was specified. Boldface text represents patient subgroups for which the dose advice was altered in 2015. Plain text represents groups for which no alteration in dose or dose interval was made
GA gestational age, NICU neonatal intensive care unit, PICU pediatric intensive care unit, PNA postnatal age
an deviates from number of patients in the total cohort or subgroups because of missing data of peak or trough concentrations