CP-134 New dosage protocol of vancomycin in neonates

BackgroundIn our hospital, most neonatal inpatients had subtherapeutic serum concentrations of vancomycin in the first therapeutic drug monitoring assessment.PurposeTo evaluate NEOFAX recommendations and to establish a new dosage protocol for vancomycin in neonates to obtain vancomycin serum concentrations of 10–15 µg/mL at the first therapeutic drug monitoring session.Material and methodsA retrospective analysis over a 25 month period from January 2014 to February 2016 was conducted. Hospitalised neonates treated with vancomycin of gestational ages 23–41 weeks were included in the study. The dosage regimen established was based in the manual drug neonatology NEOFAX, which has established the vancomycin dosage as 10 mg/kg, and varying the therapeutic range in relation to gestational age and postnatal age, every 18 hours, 12 hours, 8 hours or 6 hours. To develop a new dosage protocol, we estimated the appropriate dosage for obtaining serum vancomycin trough concentrations between 7.5 and 15 µg/mL using the pharmacokinetics programme PKS.ResultsWe reviewed the first determination of vancomycin in 43 patients; 60.5% (n=26) were preterm gestational age ≤29 weeks. Of these, 84.6% (n=22) had a postnatal age ≤14 days. 67.4% of all patients had a vancomycin trough concentration before the third dose