![]() ![]() We have undertaken a covariate analysis from therapeutic monitoring data in a cohort of neonates resident in a NICU. Concomitant drug therapy also influences clearance. Įffects of size, renal function, age (postnatal age, gestational age and postmenstrual age) as predictors of vancomycin clearance are established but the relative contribution of each component remains poorly quantified, largely because these variables are closely correlated. Low concentrations may result in less effective therapy and an increased propensity to bacterial resistance, whereas high concentrations are reported to be associated with nephrotoxicity and ototoxicity, although these toxic effects are rare in neonates and bear no obvious relationship to serum concentrations. Although there is no clear relationship between serum concentrations and a given clinical response, vancomycin dosing is commonly titrated to obtain peak serum concentrations of 20–40 mg l −1 and serum trough concentrations of 5–10 mg l −1. Vancomycin is currently the first-choice antibiotic for treatment of these infections. Coagulase-negative staphylococci and Staphylococcus aureus are the most prominent nosocomial bacterial pathogens involved in this age group. ![]() central venous catheters, endotracheal intubation). Premature neonates remain susceptible to nosocomial infections during their stay in the neonatal intensive care unit (NICU), in part due to a relative immunological incompetence and in part due to invasive techniques commonly used in this environment (e.g.
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