The optimal trough-guided monitoring of vancomycin in children: Systematic review and meta-analyses

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)781-785
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume27
Issue number5
DOIs
Publication statusPublished - 2021 May

Keywords

  • MRSA
  • Meta-analysis
  • Pediatric patient
  • Trough
  • Vancomycin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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