ISSN: 1859 - 2872
Comparison of treatment effects between continuous infusion and intermittent infusion vancomycin through therapeutic drug monitoring at City Children's Hospital
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Abstract
Objective: To compare of benefits between two methods of intravenous vancomycin infusion on pediatric patients on the basis of analysis of PK/PD, clinical efficacy and safety at City Children's Hospital. Subject and method: A descriptive cross-sectional study, from March 2022 to the end of September 2022 at City Children's Hospital. Patients applied the process of monitoring vancomycin levels in therapy, divided into 2 groups: Group 1 is intermittent infusion, group 2 is continuous infusion and the dose is adjusted according to the results of vancomycin concentration. Result: 52 patients were eligible to participate in the study. The microbiological results, mortality rate, and incidence of nephrotoxicity were similar Group 2 achieved target concentration faster (19h vs 48h, p<0.0001), the rate of reaching the target AUC24 at the first time was higher (60% vs 28.1%, p=0.023), the total daily maintenance dose was lower (60mg/kg/day versus 80mg/kg/day), and the number of dose adjustments was less (0 vs 1) compared with intermittent infusion. The infection-related mortality rate in the two groups was 0%. The rate of nephrotoxicity in group 1 was higher than in group 2 (6.3% and 0%) (p=0.517). The rate of occurrence of red man syndrome in group 1 was higher than that in group 2 (21.9% and 0%) (p=0.035). Conclusion: In children, continuous infusion of vancomycin is likely to achieve target blood concentrations more quickly than intermittent infusions. The total daily dose of vancomycin required to achieve target is lower when using continuous infusion. However, there was no difference in the incidence of vancomycin-related nephrotoxicity in the 2 groups.
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References
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