Empiric Vancomycin Dosing Recommendations in Pediatrics

Objectives : The primary objective was to determine the percentage of patients within specific age groups that fell within goal vancomycin trough range with every 6 hour and every 8-hour interval dosing. Secondary objectives were mean trough in each age group and patients that fell within goal versus not within goal. Methods: A retrospective chart review of 157 pediatric patients for one year (August 2009-2010) was conducted. Four groups were assessed: patients one month to less than eight years of age receiving vancomycin at eight- and six-hour intervals (groups one and two respectively) and eight to eighteen years of age receiving vancomycin at eight and six hour intervals (groups three and four respectively).Inferential statistics were used to conduct independent t-tests and Fischer’s exact tests to compare mean steady state trough levels, percentages and mg/kg dosing. Results : Percentage of goal vancomycin trough values were as follows: 21% group one, 59% group two, 42% group three and 40% group four. For steady state trough levels, p = 0.001 for groups one vs. two and the rest were not statistically significant (groups three vs. four, one vs. three and two vs. four). Conclusion: Patients one month to less than eight years of age may be more likely to achieve a goal vancomycin trough of ten to fifteen with every six-hour interval; however, a conclusion cannot be made on a dosing interval for patients eight to eighteen years of age since p-values were not statistically significant.