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Vancomycin drug monitoring in infants with CoNS sepsis-target attainment, microbiological response and nephrotoxicity

Journal of Perinatology volume 40, pages 97–104 (2020)Cite this article

Subjects

Abstract

Objectives

To characterize residual vancomycin concentrations (Cmin) and assess the relationships between Cmin, the risk of nephrotoxicity and persistent CoNS sepsis.

Methods

In this 5-year retrospective study among infants treated with vancomycin, the primary outcome was the proportion of those with a steady state Cmin between 10 and 20 mg/L. The secondary outcomes were nephrotoxicity and persistent CoNS sepsis.

Results

Of 120 infants included, the median first steady state Cmin was 12.4 mg/L and 77 (64%) had a Cmin between 10 and 20 mg/L. Six percent developed nephrotoxicity. This risk was not associated with Cmin. Of the 30 infants with CoNS sepsis, 17 (57%) had persistent bacteremia, and this risk did not correlate significantly with Cmin, CoNS minimal inhibitory concentration (MIC) for vancomycin, or Cmin/MIC.

Conclusions

The majority of infants achieved targeted levels of vancomycin, but persistent bacteremia was common. We did not identify a Cmin threshold associated with nephrotoxicity, nor with microbiological clearance.

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Acknowledgements

We would like to thank sincerely Nadia Desmarais, Dr Caroline Quach, and Dr Nicole Le Saux for their support throughout this project.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Centre Hospitalier de l’Université Laval, Québec, QC, Canada

    Isabelle Viel-Thériault

  2. Department of Pharmacy, CHU Sainte-Justine, Montreal, QC, Canada

    Brigitte Martin & Félix Thompson-Desormeaux

  3. Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montreal, QC, Canada

    Julie Blackburn

  4. Department of Pediatrics, Université de Montréal, Montreal, QC, Canada

    Ahmed Moussa & Julie Autmizguine

  5. Research Center, CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada

    Ahmed Moussa & Julie Autmizguine

  6. Department of Pharmacology and Physiology, Université de Montréal, Montreal, QC, Canada

    Julie Autmizguine

  7. Clinical Pharmacology Unit, Université de Montréal, Montreal, QC, Canada

    Julie Autmizguine

Authors
  1. Isabelle Viel-Thériault
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  2. Brigitte Martin
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  4. Julie Blackburn
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  5. Ahmed Moussa
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  6. Julie Autmizguine
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Contributions

All of the listed authors (IV-T, FT-D, BM, JB, AM, JA) have participated to the conception of this review. IV-T drafted the initial version. Subsequently, all of the co-authors revised the manuscript. All six authors approved the final version of the review. IV-T is the corresponding author and as such, has full access to the data and final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Isabelle Viel-Thériault.

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Viel-Thériault, I., Martin, B., Thompson-Desormeaux, F. et al. Vancomycin drug monitoring in infants with CoNS sepsis-target attainment, microbiological response and nephrotoxicity. J Perinatol 40, 97–104 (2020). https://doi.org/10.1038/s41372-019-0519-2

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