Determination of the Initial Dosage of Vancomycin in Neonates and Infants Based on the Postmenstrual Age

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  • SHIMIZU Yuichi
    Department of Pharmacy, Kanagawa Children's Medical Center Infection Control and Prevention Service Office, Kanagawa Children's Medical Center
  • SHIKAMA Yoshiaki
    Infection Control and Prevention Service Office, Kanagawa Children's Medical Center Department of Infectious Disease and Immunology, Kanagawa Children's Medical Center
  • YAMASHITA Megumi
    Infection Control and Prevention Service Office, Kanagawa Children's Medical Center
  • YOKOYA Chiemi
    Infection Control and Prevention Service Office, Kanagawa Children's Medical Center
  • IMAGAWA Tomoyuki
    Infection Control and Prevention Service Office, Kanagawa Children's Medical Center Department of Infectious Disease and Immunology, Kanagawa Children's Medical Center

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  • 月経後週数を考慮した新生児・乳児におけるバンコマイシンの初期投与量の検討

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<p>Vancomycin (VCM) dosage in neonates and infants is often based on their postnatal age and body weight. However, discrepancies in measured and target trough concentrations are common. Therefore, this study aimed to determine whether gestational age affected the trough concentrations of VCM in 84 patients at the neonatal intensive care unit from January 2016 to December 2021. The patients were divided into two groups based on the postnatal age (<1 week and ≥1 week), and two groups based on the postmenstrual age (gestational age+postnatal age, ≤37 and ≥37 weeks). Comparisons of the administered doses and trough concentrations revealed no significant differences among the four groups of patients. Conversely, significantly lower doses were observed in the ≤37-week group than in the ≥37-week group; however, no significant differences in trough concentrations were observed between the groups. These findings indicate that preterm infants with wide variations in body weight and immature renal function might be able to achieve target trough concentrations at lower VCM doses. Therefore, considering the postmenstrual age while determining the dosage of VCM might prove beneficial in controlling the blood concentration in the patient.</p>

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