Vancomycin pharmacokinetics in small, seriously ill infants
S. H. Naqvi, W. J. Keenan, R. M. Reichley and K. P. Fortune
Twenty vancomycin pharmacokinetic studies were performed on 17 small
infants who were receiving the antibiotic for treatment of documented
infections. Fourteen patients were less than or equal to 41 weeks'
postconception. In this group there was no statistical difference in mean
elimination rate, volume of distribution, or clearance between neonates and
infants 4 to 8 weeks of age. However, they had significantly lower
clearance and prolonged mean beta-half-life than infants who were 3 to 6
months old (greater than 43 weeks' postconception). Vancomycin clearance
was directly related to postconceptional age by linear regression analysis.
beta-Half-life was influenced by the weight of the patient, volume of
distribution, and gestational age. In view of the interpatient variability
observed in the prematurely born infants, pharmacokinetic studies should be
performed to determine the appropriate dose and intervals in vancomycin
therapy.
