Characteristics of the studies, PK and dose recommendations related to vancomycin
| Study | n | PNA | Weight | Type | Group | Model | Modality | Administered dose | Vd | CL | t1/2 (hours) | Recommended dose |
| Mulla and Pooboni,21 UK* | 15 | 8.2 | 3.5 | P and R | Children | 2-compartment with WinNonMix | VV–VA | 10–15 mg/kg every 6–24 hours | 0.45±0.1 L/kg ↑ | 0.04±0.02 L/kg/hour ↓ | 10.40±6.67 | — |
| Cies et al,18 USA†‡ | 12 | 9.5 | 3.1 | R | Neonates | 1-compartment with Pmetrics | VV–VA | 10–15 mg/kg every 8–24 hours | 1.2±0.4 L/kg ↑ | 0.21±0.08 L/kg/hour ↑ | 14.1±6.9 | — |
| Zylbersztajn et al,19 Chile§‡ | 24 (2–132) months | 10 (3.5–37) | P | Children | 2-compartment with Pmetrics | VV–VA | 10–15 mg/kg every 6–12 hours | 0.42±0.28 L/kg ↑ | 0.06±0.05 L/kg/hour ↔ | — | Across each dosing interval, 63.6% of patients achieved the PK/PD targets for adequate exposure. | |
| Moffett et al,20 USA§‡ | N: 28 I: 28 | 0.64 (0.07–6.7) years | 7.6 (3.7–21.9) | R | Children | 2-compartment with NONMEM | VV–VA | 25 mg/kg every 18 hours for neonates 30 mg/kg every 12 hours for infants | Vdcentral: 0.36 L/kg Vdperipheral: 0.46 L/kg ↑ | 0.06 L/kg/hour ↔ | — | 25–30 mg/kg/dose every 12–24 hours with serum concentration monitoring is a reasonable empirical dosing strategy to obtain an area under the curve for 24 hours greater than 400. |
Boldfaced fonts represent comparisons with controls within the same study. In other studies, they represent comparisons with non-ECMO neonates from a different published study.
*The reference range for serum vancomycin concentrations was trough 5–15 mg/L.
†The reference range for serum vancomycin concentrations was trough >10 mg/L.
‡De Hoog et al's neonatal PK data were used to compare Vd (0.57–0.69 L/kg) and Cl (0.04–0.09 L/kg/hour).48
§The reference range for serum vancomycin concentrations was trough <15 mg/L.
CL, clearance; ECMO, extracorporeal membrane oxygenation; I, infants; N, neonates; NONMEM, non-linear mixed-effects modelling; P, prospective; PD, pharmacodynamics; PK, pharmacokinetics; PNA, postnatal age; R, retrospective; t1/2, elimination half-life; VA, veno-arterial; Vd, volume of distribution; VV, veno-venous.