Vancomycin pharmacokinetics and dose recommendations for preterm infants

The pharmacokinetics of intravenous vancomycin was studied in 20 preterm infants (gestational age, 26.5 weeks ± 2.6 weeks [standard deviation]; birthweight, 880 ± 340 g). At the time of the studies their postconceptional age was 36.4 ± 4.5 weeks. The drug was infused over 30 min in a dose between 9.2 and 18 mg/kg. A highly significant correlation existed between postconceptional age or body weight and vancomycin t( 1/2 ) and clearance. Serum creatinine concentrations correlated with vancomycin t( 1/2 ) and clearance. Serum creatinine tended to decrease with increasing postconceptional age. Based on the excellent correlation between age (or weight) and vancomycin pharmacokinetics, dose and dose-interval recommendations are presented.