Evolution of empiric vancomycin dosing in a neonatal population

J Perinatol. 2018 Dec;38(12):1702-1707. doi: 10.1038/s41372-018-0251-3. Epub 2018 Oct 19.


Background: In 2014, we assessed the effectiveness of our neonatal vancomycin empirical dosing regimen (15-45 mg/kg/day) which led to development of a revised regimen (20-60 mg/kg/day).

Objective: To validate the revised empirical vancomycin dosage regimen in achieving target troughs.

Methods: The primary outcome of this multicenter retrospective before-and-after cohort study was the proportion of neonates in the present cohort achieving trough levels below, at or above target (<10, 10-20 and >20 mg/L). Secondary outcomes included difference between cohorts (historical and present) in mean troughs and proportion of patients achieving target levels.

Results: Out of 118 participants, 63 (53.39%) achieved target troughs, 44 (37.29%) had below target troughs and 11 (9.32%) reached above target levels. Mean trough levels and proportion of patients achieving target levels were higher in the present versus historical cohort (p < 0.01 for all comparisons).

Conclusions: The revised empiric dosing regimen was more effective in achieving target serum trough concentrations.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / pharmacokinetics*
  • Female
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Linear Models
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Retrospective Studies
  • Serum / chemistry
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Vancomycin / administration & dosage*
  • Vancomycin / adverse effects
  • Vancomycin / pharmacokinetics*


  • Anti-Bacterial Agents
  • Vancomycin