Pharmacokinetics of Vancomycin in Paediatric Patients Receiving Haemodialysis and Haemodiafiltration

Optimal vancomycin dosing in paediatric patients requiring haemodialysis (HD) or haemodiafiltration (HDF) remains unknown. The current study aimed to characterize vancomycin pharmacokinetics in this population. The pharmacokinetic parameters were estimated using a single compartment model and least-squares algorithm. The mean drug removal was 56.38% immediately post-dialysis, rebound was 23% post-redistribution, and net drug removal was 43% for patients on vancomycin undergoing HD/HDF. While on HD/HDF, the median elimination constant (ke) was 0.32h-1, and clearance was 0.18L/kg/h. When off dialysis, the median ke was 0.013h-1, clearance was 0.0066L/kg/h and volume of distribution was 0.64L/kg. All patients who received vancomycin 10 mg/kg/dose post-dialysis for proven infections were successfully treated. No adverse effects were reported except for one case of Redman syndrome. Monte Carlo simulations demonstrated that the current regimen is optimal to reach therapeutic range for 4-hour post-dialysis vancomycin concentrations and 24-h area under the curve over minimum inhibitory concentration â Ľ400.M.Sc.2018-11-06 00:00:0