首页 | 本学科首页   官方微博 | 高级检索  
     


The optimal trough-guided monitoring of vancomycin in children: Systematic review and meta-analyses
Authors:Hiromu Moriyama  Moeko Tsutsuura  Nana Kojima  Yuki Mizukami  Sho Tashiro  Sumika Osa  Yuki Enoki  Kazuaki Taguchi  Kazutaka Oda  Satoshi Fujii  Yoshiko Takahashi  Yukihiro Hamada  Toshimi Kimura  Yoshio Takesue  Kazuaki Matsumoto
Affiliation:1. Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan;2. Department of Pharmacy, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan;3. Department of Hospital Pharmacy, Sapporo Medical University Hospital, 16-291, South 1, West 16, Chuo-ku, Sapporo-shi, Hokkaido, 060-8543, Japan;4. Department of Pharmacy, Hyogo College of Medicine, 1-1, Mukogawa-machi, Nishinomiya-shi, Hyogo, 663-8501, Japan;5. Department of Pharmacy, Tokyo Women''s Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan;6. Department of Infection Control and Prevention, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan;1. First Department of Internal Medicine, Shinshu University School of Medicine, 3-1-1, Asahi Matsumoto City, Nagano, 390-8621, Japan;2. Center of Infectious Diseases, Nagano Prefectural Shinshu Medical Center, 1332, Suzaka, Suzaka City, Nagano, 382-8577, Japan;3. Department of Respiratory Medicine, Minaminagano Medical Center, Shinonoi General Hospital, 666-1 Ai, Shinonoi, Nagano City, Nagano, 388-8004, Japan;4. Department of Respiratory Medicine, Japanese Red Cross Society Suwa Hospital, 5-11-50, Kogandori, Suwa City, Nagano, 392-8510, Japan;5. Department of Respiratory Medicine, Nagano Municipal Hospital, 1333-1, Tomitake, Nagano City, Nagano, 381-8551, Japan;6. Department of Respiratory Medicine, Japanese Red Cross Society Nagano Hospital, 5-22-1, Wakasato, Nagano City, Nagano, 380-8582, Japan;1. Division of Bioresources, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan;2. Laboratory of Food Microbiology and Food Safety, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan;3. Department of Biochemistry, Chulalongkorn University, Bangkok, Thailand;4. Quality Vet Product Co., Ltd, Klongsamwa District, Bangkok, Thailand;5. International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan;1. Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan;3. Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan;1. Medical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, Turkey;2. Medical School of Ege University, Department of Microbiology and Infectious Diseases, Izmir, Turkey;1. Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan;2. Victorian Infectious Diseases Reference Laboratory, At the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC, 3004, Australia;3. Department of Health and Welfare, Akita Prefectural Government, 4-1-1 Sanno, Akita City, Akita, 010-8570, Japan
Abstract:
We carried out a systematic review and meta-analysis exploring the relationship between vancomycin (VCM) trough concentrations and its effectiveness and nephrotoxicity in pediatric patients. We conducted our analysis using MEDLINE, Web of Sciences, and Cochrane Register of Controlled Trials as electronic databases (June 29, 2019). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. We identified 16 studies that were eligible for the meta-analysis. A total of 351 and 3,266 patients were included in the analysis for effectiveness and nephrotoxicity, respectively. Pediatric MRSA infection patients with VCM trough concentrations ≥ 10 μg/mL had significantly lower treatment failure rates (OR 0.54, 95% CI 0.30–0.96). The incidence of nephrotoxicity was significantly higher in trough concentrations ≥ 15 μg/mL than when they were < 15 μg/mL (OR 3.02, 95% CI 2.08–4.38). We identified the optimal VCM trough concentrations associated with effectiveness and nephrotoxicity in pediatric patients with MRSA infection. Further prospective studies are needed to find optimal dosing and monitoring strategy on VCM in pediatric population.
Keywords:MRSA  Vancomycin  Trough  Pediatric patient  Meta-analysis
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号