In 2015, age- and weight-based dosing guidelines in the Dutch Pediatric Formulary were updated for vancomycin, gentamicin, and tobramycin based on published population pharmacokinetic studies. Target attainment resulting from these model-based doses was unknown.

This study shows that both sub- and supratherapeutic concentrations of vancomycin, gentamicin, and tobramycin are frequently observed, with serum creatinine levels related to the observed variability.

Future dosing recommendations should aim to be further individualized by including relevant covariates to address the remaining interindividual variability.