| Title |
Factors impacting unbound vancomycin concentrations in neonates and young infants
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, May 2018
|
| DOI | 10.1007/s10096-018-3277-8 |
| Pubmed ID | |
| Authors |
Anne Smits, Steven Pauwels, Matthijs Oyaert, Nele Peersman, Isabel Spriet, Veroniek Saegeman, Karel Allegaert |
| Abstract |
Vancomycin pharmacokinetic (PK) and pharmacodynamic (PD) data in neonates are based on total concentrations. However, only unbound vancomycin is pharmacologically active. The objective was to determine vancomycin protein binding and the covariates impacting unbound vancomycin concentration in neonates and young infants. In neonates and young infants to whom vancomycin was administered intermittently for medical indications, total and unbound vancomycin plasma concentrations were determined using LC-MS/MS. Sampling occurred randomly during vancomycin exposure, covering a broad range of concentrations. Impact of covariates on unbound vancomycin concentration was determined using linear regression. Significant results of the univariate regressions were entered in a stepwise multiple regression. Passing-Bablok regression and Bland-Altman were used to assess the difference between measured and calculated unbound vancomycin concentration. Thirty-seven samples in 33 patients (median (interquartile range) gestational age 35 (29-39) weeks) were collected. Median total and unbound vancomycin concentrations were 14.2 (7.4-20.6) and 13.6 (7.2-22.5) mg/L, respectively. Median unbound fraction was 0.90 (0.77-0.98). Multiple regression revealed total vancomycin concentration (β = 0.884, p < 0.001) and albumin (β = - 0.323, p = 0.007) as most important covariates of unbound vancomycin concentrations, with an R2 adjusted of 0.953 (p < 0.0001). Mean absolute difference between calculated and measured unbound vancomycin was - 0.008 (95% CI - 0.92-0.91) mg/L. The unbound vancomycin fraction in neonates is higher compared to that in children and adults, and total vancomycin concentration and albumin were the most important covariates of unbound vancomycin concentration. Integration of protein binding in future PK/PD analyses is appropriate to optimize vancomycin dosing and to determine population-specific vancomycin PD targets for neonates. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| United Kingdom | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 40 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 7 | 18% |
| Other | 6 | 15% |
| Researcher | 6 | 15% |
| Student > Master | 3 | 8% |
| Student > Postgraduate | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 13 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 28% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 15% |
| Veterinary Science and Veterinary Medicine | 2 | 5% |
| Environmental Science | 1 | 3% |
| Computer Science | 1 | 3% |
| Other | 3 | 8% |
| Unknown | 16 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 July 2018.
All research outputs
#15,489,360
of 23,096,849 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#1,885
of 2,799 outputs
Outputs of similar age
#207,849
of 327,798 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#19
of 45 outputs
Altmetric has tracked 23,096,849 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
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We're also able to compare this research output to 45 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.