Vancomycin dosage in overweight and obese children

Misty Miller, Jamie L. Miller, Tracy Hagemann, Donald Harrison, Susana Chavez-Bueno, Peter N. Johnson

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose. Vancomycin dosages in overweight and obese children were evaluated. Methods. This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 μg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 μg/mL) and independent variables. Results. Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037). Conclusion. A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 μg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 μg/mL.

Original languageEnglish (US)
Pages (from-to)2062-2068
Number of pages7
JournalAmerican Journal of Health-System Pharmacy
Volume68
Issue number21
DOIs
StatePublished - Nov 1 2011
Externally publishedYes

Fingerprint

Vancomycin
Weights and Measures
Multivariate Analysis
Retrospective Studies
Logistic Models
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Health Policy

Cite this

Miller, M., Miller, J. L., Hagemann, T., Harrison, D., Chavez-Bueno, S., & Johnson, P. N. (2011). Vancomycin dosage in overweight and obese children. American Journal of Health-System Pharmacy, 68(21), 2062-2068. https://doi.org/10.2146/ajhp110107

Vancomycin dosage in overweight and obese children. / Miller, Misty; Miller, Jamie L.; Hagemann, Tracy; Harrison, Donald; Chavez-Bueno, Susana; Johnson, Peter N.

In: American Journal of Health-System Pharmacy, Vol. 68, No. 21, 01.11.2011, p. 2062-2068.

Research output: Contribution to journalArticle

Miller, M, Miller, JL, Hagemann, T, Harrison, D, Chavez-Bueno, S & Johnson, PN 2011, 'Vancomycin dosage in overweight and obese children', American Journal of Health-System Pharmacy, vol. 68, no. 21, pp. 2062-2068. https://doi.org/10.2146/ajhp110107
Miller M, Miller JL, Hagemann T, Harrison D, Chavez-Bueno S, Johnson PN. Vancomycin dosage in overweight and obese children. American Journal of Health-System Pharmacy. 2011 Nov 1;68(21):2062-2068. https://doi.org/10.2146/ajhp110107
Miller, Misty ; Miller, Jamie L. ; Hagemann, Tracy ; Harrison, Donald ; Chavez-Bueno, Susana ; Johnson, Peter N. / Vancomycin dosage in overweight and obese children. In: American Journal of Health-System Pharmacy. 2011 ; Vol. 68, No. 21. pp. 2062-2068.
@article{8a5eb49c1fd041cf931df7157204fad5,
title = "Vancomycin dosage in overweight and obese children",
abstract = "Purpose. Vancomycin dosages in overweight and obese children were evaluated. Methods. This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 μg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 μg/mL) and independent variables. Results. Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037). Conclusion. A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 μg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 μg/mL.",
author = "Misty Miller and Miller, {Jamie L.} and Tracy Hagemann and Donald Harrison and Susana Chavez-Bueno and Johnson, {Peter N.}",
year = "2011",
month = "11",
day = "1",
doi = "10.2146/ajhp110107",
language = "English (US)",
volume = "68",
pages = "2062--2068",
journal = "American Journal of Health-System Pharmacy",
issn = "1079-2082",
publisher = "American Society of Health-Systems Pharmacy",
number = "21",

}

TY - JOUR

T1 - Vancomycin dosage in overweight and obese children

AU - Miller, Misty

AU - Miller, Jamie L.

AU - Hagemann, Tracy

AU - Harrison, Donald

AU - Chavez-Bueno, Susana

AU - Johnson, Peter N.

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Purpose. Vancomycin dosages in overweight and obese children were evaluated. Methods. This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 μg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 μg/mL) and independent variables. Results. Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037). Conclusion. A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 μg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 μg/mL.

AB - Purpose. Vancomycin dosages in overweight and obese children were evaluated. Methods. This retrospective study evaluated data for children who were age 2-17 years, received i.v. vancomycin, and were admitted to a children's hospital from September 1, 2007, through October 31, 2009. Patients were then stratified into two groups: normal-weight patients and overweight or obese patients. The primary objective was to compare the number of vancomycin regimens between groups with a trough concentration of 5-15 μg/mL. Secondary objectives included a comparison of dosage changes and toxicities. Multivariate, conditional logistic regression was performed to assess the relationship between attaining optimal vancomycin concentrations (5-15 μg/mL) and independent variables. Results. Data were collected for 232 courses of vancomycin, representing 187 patients. The mean ± S.D. initial dose for the normal-weight and overweight or obese groups differed significantly (461.3 ± 303.1 mg and 658.4 ± 389.6 mg, respectively; p < 0.01); the milligram-per-kilogram initial vancomycin dose did not. The multivariate analysis revealed that every-eight-hour regimens had increased odds of achieving therapeutic concentrations (p < 0.001), while obese children had decreased odds of achieving therapeutic concentrations (p = 0.037). Conclusion. A study of prescribing behavior in one hospital revealed no significant difference in the size of vancomycin doses (in milligrams per kilogram) given to normal-weight children compared with overweight or obese children. Regimens using every-eight-hour dosing were significantly more likely than other regimens to result in a vancomycin trough concentration of 5-15 μg/mL, and regimens for obese children, compared with regimens for nonobese children, were less likely to produce trough concentrations in the same range of 5-15 μg/mL.

UR - http://www.scopus.com/inward/record.url?scp=80455144700&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80455144700&partnerID=8YFLogxK

U2 - 10.2146/ajhp110107

DO - 10.2146/ajhp110107

M3 - Article

VL - 68

SP - 2062

EP - 2068

JO - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 21

ER -