Abstract��OBJECTIVE To optimize vancomycin regimen in children with MRSA infection. METHODS Vancomycin AUC0-24/MIC predictions were performed across a range of dosages (20-70 mg��kg-1��d-1) using a Monte Carlo simulation (n=10 000). AUC0-24 was calculated as daily dose divided by vancomycin clearance, and daily dose was fixed for a given simulation. The MIC distribution for MRSA was obtained from the RESULTS of clinical laboratory, the First Affiliated Hospital of Guangxi Medical University, from 2012 to 2014 (n=430;30%��0.5 mg��L-1; 58.6%= 12 mg��L-1; and 11.2%=2 mg��L-1; 0.2%=4 mg��L-1). RESULTS With increasing vancomycin daily dose, the percentage of patients predicted to achieve AUC0-24/MIC >400 similarly increased. At 35 mg��kg-1��d-1, the percentage predicted to achieve AUC0-24/MIC >400 was 99.41% when MIC was 0.5 mg��L-1. However, the dosage rose to 65 mg��kg-1��d-1 when MIC was 1 mg��L-1. At this regimen, the percentage predicted to achieve AUC0-24/MIC >400 was 97.55%. At a MIC of 2 mg��L-1 and more, none of the dosages predicted to achieve AUC0-24/MIC>400. CONCLUSION Recommended empiric vancomycin dosing in children should be above 35 mg��kg-1��d-1 when MIC is 0.5 mg��L-1. At the MIC is 1 mg��L-1, the recommended regimen should be over 65 mg��kg-1��d-1.
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ZHANG Hong-liang , HUANG Zhen-guang , QIU Yue, LI Meng, LIU Tao-tao. Optimizing Vancomycin Regimen in Children with MRSA Infections Based on PK/PD Model and Monte Carlo Simulation. Chinese Pharmaceutical Journal, 2017, 52(3): 217-220.
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