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

doi:10.1016/j.jiac.2021.01.015

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

School of Pharmacy

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

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 language	English
Pages (from-to)	781-785
Number of pages	5
Journal	Journal of Infection and Chemotherapy
Volume	27
Issue number	5
DOIs	https://doi.org/10.1016/j.jiac.2021.01.015
Publication status	Published - 2021 May

Keywords

MRSA
Meta-analysis
Pediatric patient
Trough
Vancomycin

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jiac.2021.01.015

Cite this

Moriyama, H., Tsutsuura, M., Kojima, N., Mizukami, Y., Tashiro, S., Osa, S., Enoki, Y., Taguchi, K., Oda, K., Fujii, S., Takahashi, Y., Hamada, Y., Kimura, T., Takesue, Y., & Matsumoto, K. (2021). The optimal trough-guided monitoring of vancomycin in children: Systematic review and meta-analyses. Journal of Infection and Chemotherapy, 27(5), 781-785. https://doi.org/10.1016/j.jiac.2021.01.015

Moriyama, H, Tsutsuura, M, Kojima, N, Mizukami, Y, Tashiro, S, Osa, S, Enoki, Y , Taguchi, K, Oda, K, Fujii, S, Takahashi, Y, Hamada, Y, Kimura, T, Takesue, Y & Matsumoto, K 2021, 'The optimal trough-guided monitoring of vancomycin in children: Systematic review and meta-analyses', Journal of Infection and Chemotherapy, vol. 27, no. 5, pp. 781-785. https://doi.org/10.1016/j.jiac.2021.01.015

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

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, Meta-analysis, Pediatric patient, Trough, Vancomycin",

author = "Hiromu Moriyama and Moeko Tsutsuura and Nana Kojima and Yuki Mizukami and Sho Tashiro and Sumika Osa and Yuki Enoki and Kazuaki Taguchi and Kazutaka Oda and Satoshi Fujii and Yoshiko Takahashi and Yukihiro Hamada and Toshimi Kimura and Yoshio Takesue and Kazuaki Matsumoto",

note = "Funding Information: HM, MT, NK, YM, ST, SO, YE, KT, SF, YT, YH and TK report no conflicts of interest. YT received research grants from Dainippon Sumitomo Pharm Co., Ltd. , Astellas Pharm, Inc. , and MSD Japan. KM received a research grant from Meiji Seika Pharma Co., Ltd. Funding Information: HM, MT, NK, YM, ST, SO, YE, KT, SF, YT, YH and TK report no conflicts of interest. YT received research grants from Dainippon Sumitomo Pharm Co., Ltd., Astellas Pharm, Inc., and MSD Japan. KM received a research grant from Meiji Seika Pharma Co., Ltd. Publisher Copyright: {\textcopyright} 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases",

year = "2021",

month = may,

doi = "10.1016/j.jiac.2021.01.015",

language = "English",

volume = "27",

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T1 - The optimal trough-guided monitoring of vancomycin in children

T2 - Systematic review and meta-analyses

AU - Moriyama, Hiromu

AU - Tsutsuura, Moeko

AU - Kojima, Nana

AU - Mizukami, Yuki

AU - Tashiro, Sho

AU - Osa, Sumika

AU - Enoki, Yuki

AU - Taguchi, Kazuaki

AU - Oda, Kazutaka

AU - Fujii, Satoshi

AU - Takahashi, Yoshiko

AU - Hamada, Yukihiro

AU - Kimura, Toshimi

AU - Takesue, Yoshio

AU - Matsumoto, Kazuaki

N1 - Funding Information: HM, MT, NK, YM, ST, SO, YE, KT, SF, YT, YH and TK report no conflicts of interest. YT received research grants from Dainippon Sumitomo Pharm Co., Ltd. , Astellas Pharm, Inc. , and MSD Japan. KM received a research grant from Meiji Seika Pharma Co., Ltd. Funding Information: HM, MT, NK, YM, ST, SO, YE, KT, SF, YT, YH and TK report no conflicts of interest. YT received research grants from Dainippon Sumitomo Pharm Co., Ltd., Astellas Pharm, Inc., and MSD Japan. KM received a research grant from Meiji Seika Pharma Co., Ltd. Publisher Copyright: © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

PY - 2021/5

Y1 - 2021/5

N2 - 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.

AB - 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.

KW - MRSA

KW - Meta-analysis

KW - Pediatric patient

KW - Trough

KW - Vancomycin

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SN - 1341-321X

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JO - Journal of Infection and Chemotherapy

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ER -

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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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