An error occurred in the January 2008 issue of Pediatrics (Volume 121, Supplement 2). On page S138, under the section Neonatology, after line 19 the authors should have included the following abstract:
CONTINUOUS-INFUSION VANCOMYCIN THERAPY IN THE NEONATAL POPULATION IMPROVES VANCOMYCIN SERUM CONCENTRATIONS
Submitted by Andrew Kapetanakis
Andrew Kapetanakis, Sarah Bradley, Kate Farrer
Neonatal Unit, St George's Hospital, London, UK
BACKGROUND: Vancomycin is a valuable antibiotic in neonatal intensive care although the optimal administration regime has not been established. Intermittent drug administration regimens do not produce consistently satisfactory drug levels. The most important pharmacokinetic parameter is the 24-hour area under the serum concentration time concentration curve (24 h AUC) in relation to minimal inhibitory concentration (MIC). Continuous infusion (CI) of Vancomycin would therefore be more appropriate in improving serum drug concentrations and bactericidal activity. To date there is limited experience of CI-Vancomycin therapy in neonates.
OBJECTIVE: To evaluate the use of a new CI-Vancomycin therapy regimen in neonates.
DESIGN & METHODS: Prospective data collection from infants receiving a loading dose of 15 mg/kg followed by CI-Vancomycin. The starting doses were 15 mg/kg/day - 30 mg/kg/day depending on the initial serum creatinine level. Drug levels were obtained at 24-48 hour intervals and the dose adjusted accordingly. Target steady state concentration was 15-25 mcg/ml.
RESULTS: (Mean ± Standard deviation): 111 Vancomycin courses were evaluated between November 2002 and November 2006. Gestational age was 28.5 (±5) weeks and birth weight was 1.24 (±0.88) kg. Corrected age was 34.9 (±8) weeks. The dosing schedule was adjusted 2.4 (±2) times. The duration of the treatment was 12.5 (±5.8) days. 48-hour steady state vancomycin concentration was 16.25 (±8.2) mcg/ml (63% >15 mcg/ml) and was improved further during the treatment course.
CONCLUSIONS: CI-Vancomycin administration was well tolerated and resulted in improved drug concentrations in the neonatal population. Drug levels need to be monitored regularly and the dose needs to be adjusted accordingly to achieve optimal results.