0000002916 00000 n To calculate patient-specific V and K, at least two levels need to be drawn. Pediatric Dosage Handbook, 15th Edition, 2008 2. To check the peak-trough results, use the SS Trough calculator; if the difference between the measured AUC and the trough-only estimated AUC is >100 then there’s probably something wrong with the data or how it was entered into the calculator.A new vancomycin calculator will available soon (Fall 2020) that will calculate dosage based on a goal AUC or goal trough and will have some new features.
9 28 A regimen can be completely empiric, where the vancomycin dose is based on body weight and creatinine clearance, or a regimen may be calculated based on one or more vancomycin levels. This calculator will work better on modern browser including Google Chrome, Mozilla Firefox, Safari, and Microsoft EdgeUpdate (September 2020): A sample of size 1879 SS peak and trough couplets were reviewed and 1595 were included and analyzed with multiple regression to find an equation for Vd: Vd = 0.23*age + 0.27*total body weight +22.
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0000006973 00000 n The mean measured AUC was 502; the mean trough-only estimated AUC was 492. Current guidelines recommend pediatric dosing of vancomycin 40–60 mg/kg/day, but literature reports that doses of 80–90 mg/kg/day may be required to attain therapeutic levels [1,2,3]. 0000003624 00000 n Current Recommended Dosing of Vancomycin for Children With Invasive Methicillin-Resistant Staphylococcus aureus Infections is Inadequate.
3. 0000046349 00000 n 0000003378 00000 n 0000000016 00000 n < 0000004503 00000 n 0000001906 00000 n 0000046802 00000 n 0000003144 00000 n
9 0 obj <> endobj AUCs were measured from the data, and compared to AUCs estimated from the SS Trough Calculator (which uses the new Vd equation and first-order PK equations). 0000005264 00000 n 0000006211 00000 n 0000001084 00000 n This data helps to validate the SS Trough calculator’s ability to estimate AUCs, but dosage should be titrated to target an AUC near 500 to ensure that the AUC is within goal.The most accurate way to measure an AUC is by checking a steady-state peak and trough but this requires extra bloodwork so patient discomfort and extra work for healthcare staff should be weighed against the need for improved AUC accuracy. 90% (1440/1595) of the estimated AUCs were within 15% of the measured AUCs. Initial Vancomycin Dosing in Pediatric Oncology and Stem Cell Transplant Patients. To calculate an initial dose these parameters are estimated based on population kinetics. 0000009346 00000 n In clinical practice a 'trough-only' approach is often used, but this only allows rough estimation of Vd, Ke, and … xref This vancomycin calculator uses a variety of published pharmacokinetic equations and principles to estimate a vancomycin dosing regimen for a patient. 0000007580 00000 n
0000006081 00000 n %PDF-1.4 %���� Ped Infect Dis J 2009; 28(5):398-402. 0000002335 00000 n 0000001162 00000 n
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Also, when measuring a peak and trough, small discrepancies in how the levels are drawn or reported can greatly impact the results in first-order PK equations. The standard deviation between the estimated and measured AUCs was 44 mg*hr/L. Piro C et al. 0000008281 00000 n 0000000856 00000 n 0000001485 00000 n 0000008784 00000 n 0000035899 00000 n EMPIRIC DOSING AND MONITORING RECOMMENDATIONS FOR VANCOMYCIN IN PEDIATRIC PATIENTS (<18 YEARS OF AGE) Patient Population/ Unit/Service Empiric Dosing Recommendations Timing of Initial Serum Concentrations NICU Less than 7 days and less than 1200 g: 15 mg/kg/dose IV q24h Less than 7 days and 1200-2000 g: 15 mg/kg/dose IV q18h 1. Frymoyer A et al. 0000001341 00000 n
Vancomycin kinetics depends on two PK parameters: Volume of distribution (V) and elimination rate constant (K). 0000046594 00000 n
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