. The RCH data set included 3,687 vancomycin concentrations from 627 children. A two-compartment model with renal maturation best described the data. External validation (PCH 175, SCH 58, and CHW 170 concentrations) showed adequate predictive performance. The optimized dosing strategy achieved a target attainment of 73% versus 44% with the standard 15 mg/kg of body weight administered every 6 h. Improvement was most notable in patients <4 years, where the probability of target attainment (PTA) increased from 10.5%-48% to 66.1%-80% with the optimized regimen. A 25 mg/kg loading dose significantly increased the initial 24-h PTA to 57%, compared to 23% without a loading dose. We developed an optimized vancomycin dosing strategy that achieved the therapeutic target in 73% of children. This regimen requires prospective clinical validation.
Xu et al. (Tue,) studied this question.