Abstract
Background Vancomycin is a frequently used antibiotic in neonates. However, there is no consensus guideline on the optimal dosing regimen and therapeutic drug monitoring (TDM) practices in this patient population. Objective To document the variability in the current dosing and TDM practices in neonatal intensive care units (NICU). Setting Belgian and Dutch NICUs. Method An online questionnaire was disseminated by e-mail to potential respondents. Main outcome measure Differences in vancomycin dosing and TDM practices in comparison with a reference source, the Dutch Paediatric Formulary. Results Eighteen NICUs (response rate 62%) participated. Eleven different dosing regimens are applied, with 83% using intermittent dosing regimens. Stratifying covariates used to determine the (initial) dosage include gestational age, postnatal age, serum creatinine, concurrent use of non-steroidal anti-inflammatory drugs, birth weight and current weight. Large variability is observed with regard to TDM practice as well, both for the concentration target range and the times of (re)sampling. Dosing calculators are more commonly used in the Netherlands than Belgium. Conclusion Significant inter-centre variability in dosing and TDM practices was found. The development of international consensus guidelines is required to optimize therapy. Dosing calculators to guide dosing are not yet considered as part of standard-of-care.
| Original language | English |
|---|---|
| Pages (from-to) | 564-569 |
| Number of pages | 6 |
| Journal | International Journal of Clinical Pharmacy |
| Volume | 44 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2022 |
Bibliographical note
Funding Information:The authors would like to thank all of the respondents: Belgium : A. Smits (UZ Leuven), L. Mahieu (UZ Antwerpen), B. De Bisschop (UZ Brussel), UZ Gent, W. Decaluwe and S. Desmet (AZ Sint-Jan Brugge), M. Carrette (AZ Sint-Augustinus), N. Segers (ZNA Paola kinderziekenhuis), E. Rotunno (CHU St.Pierre), F. Vermeulen (Hopital Erasme), P. Maton (CHC), A. Bachy (Grand Hopital de Charleroi), UCL. The Netherlands : L. Derijks (Maxima Medical Center Veldhoven), R. Flint (Erasmus MC Rotterdam), F. Sombogaard (Amsterdam MC), M. S. Bolhuis (UMCG Groningen), R. ter Heine (Radboud UMC Nijmegen). E. M. Van Maarseveen (UMC Utrecht). The authors would like to thank Professor Mark Turner for critically reading the manuscript.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.