Zylbersztajn Brenda Lara, Chicco Pamela, Vega Laura, Centeno Mónica, Filippini Silvia, Ruvinsky Silvina
Hospital de Pediatría Prof. Dr. Juan P. Garrahan.
Arch Argent Pediatr. 2013 Jan-Feb;111(1):e31-4. doi: 10.5546/aap.2013.e31.
Continuous infusion of vancomycin may be a strategy for critically ill patients who do not achieve adequate plasma levels. There is few literature on this dosage regimen. We present six children (2 months to 7 years, 4 male and 2 female), admitted to the Intensive Care Unit of the "Prof. Dr. Garrahan Children Hospital", with methicillin-resistant Staphylococcus aureus sepsis, treated with vancomycin 40 and 60 mg/kg/day every 8-6 hrs. Continuous infusion at 50 mg/kg/day was implemented due to poor outcome, persistent fever, positive cultures and inadequate vancomycin plasma levels. All patients achieved levels between 10 and 25 ug/ml, their outcome was favorable and cultures became negative, with no signs of nephrotoxicity. Treatment duration of the continuous infusion was 9 to 18 days. Continuous infusion of vancomycin was effective in these patients without evidence of associated nephrotoxicity.
对于血浆水平未达足够浓度的重症患者,持续输注万古霉素可能是一种治疗策略。关于这种给药方案的文献较少。我们报告了6名儿童(年龄从2个月至7岁,4名男性,2名女性),他们因耐甲氧西林金黄色葡萄球菌败血症入住“加拉汉教授儿童医院”重症监护病房,最初每8至6小时接受40和60mg/kg/天的万古霉素治疗。由于治疗效果不佳、持续发热、培养结果阳性以及万古霉素血浆水平不足,改为50mg/kg/天持续输注。所有患者的血药浓度达到10至25μg/ml,治疗效果良好,培养结果转阴,且无肾毒性迹象。持续输注的治疗时间为9至18天。万古霉素持续输注对这些患者有效,且未发现相关肾毒性证据。