{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:16:11Z","timestamp":1780758971199,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Vancomycin guidelines for therapeutic drug monitoring (TDM) aim to maximise efficacy while minimising toxicity and resistance. Vancomycin is effective against <jats:italic>Staphylococcus aureus<\/jats:italic> when it achieves area under the concentration\u2013time curve (AUC)\/minimum inhibitory concentration (MIC)\u2009&gt;\u2009400. Studies in children have shown that target trough concentrations poorly correlate to AUC\/MIC\u2009&gt;\u2009400; however, they are used in practice for clinical convenience. This review in paediatric inpatients aims to audit performance against TDM guidelines and consider what changes are needed to optimise vancomycin monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vancomycin prescriptions in patients younger than 18\u2009years old were collected over a 15\u2010month period. Primary outcome measures were vancomycin initial dose (mg\/kg\/day) and the timing and result of first trough concentration (mg\/L). Secondary outcome measures were the numbers achieving recommended targets and whether appropriate dose adjustments were made in response to TDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 133 courses reached the time when TDM should occur. Average patient age was 6.5\u2009years, and the average initial dose was 52.55\u2009mg\/kg\/day (range 19.05\u201386.54\u2009mg\/kg). Only 25% of courses (<jats:italic>n<\/jats:italic> =\u200934) had a trough concentration measured at the recommended time. The mean trough concentration was 11.6 mg\/L (range\u2009&lt;\u20092.0\u201339.7). Of 40 patients with a low trough concentration, 50% continued without dose adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As shown in the literature, there is a poor correlation between the vancomycin dose given and the trough concentration achieved. Given that recommendations for trough concentration monitoring are designed to simplify the process yet are poorly adhered to, a strategic plan to address these issues is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14683","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T14:40:09Z","timestamp":1573656009000},"page":"563-570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Vancomycin therapeutic drug monitoring in paediatrics"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-6957","authenticated-orcid":false,"given":"Joanne","family":"Patel","sequence":"first","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Division of Medicine John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J","family":"Lucas","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Division of Medicine John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ryan","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Division of Medicine John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Cancer Centre for Children, The Children's Hospital at Westmead  Westmead New South Wales Australia"},{"name":"Paediatrics, John Hunter Children's Hospital, Kookaburra Cct  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Division of Medicine John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H","family":"Martin","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Division of Medicine John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Therapeutic Guidelines.Antimicrobial Drug Information; 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