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20. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI)

Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI)

19.04. - 21.04.2012, Mannheim

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Intrapulmonary Concentrations of Vancomycin in Critical ill Neonates

Meeting Abstract

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  • presenting/speaker Andreas Müller - Zentrum für Kinderheilkunde, Universitätsklinikum Bonn, Neonatologie, Bonn
  • Soyhan Bagci - Zentrum für Kinderheilkunde, Universitätsklinikum Bonn, Neonatologie, Bonn
  • Werner Neubauer - Institut für Umweltmedizin, Universitätsklinik Freiburg, Freiburg
  • Armin König - Institut für Umweltmedizin, Universitätsklinik Freiburg, Freiburg
  • Bernd Zur - Institut für klinische Biochemie, Uniklinikum Bonn, Bonn
  • Richard Bolek - Institut für Umweltmedizin, Universitätsklinik Freiburg, Freiburg
  • Klaus Kümmerer - Institut für Umweltmedizin, Universitätsklinik Freiburg, Freiburg

Deutsche Gesellschaft für Pädiatrische Infektiologie. 20. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI). Mannheim, 19.-21.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgpi59

doi: 10.3205/12dgpi59, urn:nbn:de:0183-12dgpi592

Published: March 22, 2012

© 2012 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: In this study our objective was to determine the intrapulmonary concentration of vancomycin in critical ill mechanically ventilated neonates treated with intravenous vancomycin because of proven or suspected infection with Gram + bacteria.

Methods: Bronchial and serum samples were taken before the application of vancomycin as trough value. Vancomycin and urea concentrations in bronchial and serum samples were determined by HPLC. Urea was used as an endogenous marker (dilution marker) for calculation of the amount of the epithelial lining fluid (ELF) and subsequent of the concentration of vancomycin in the ELF.

Results: Twenty one samples of 18 neonates with median gestation age 26.0 weeks (IQR 23-38) and median birth weight of 978g (IQR 580-3600) were collected in the study. The median serum and ELF concentration of vancomycin were 8.9µg/ml (IQR 4.9-12.0) and 102.35µg/ml (IQR 39.59-188.12). The vancomycin (ELF) / vancomycin (Serum) ratio was 10.44 (IQR 8.06-24.78) and were significant higher in neonates below the 32 weeks of gestation (24.740, IQR 10.44-36.29) in comparison to neonates above 32 weeks of gestation (6.180, IQR 2.795-9.685).

Conclusions: The results suggest that the intrapulmonary concentration of vancomycin are above the serum concentration and indicate that vancomycin is likely to be an effective agent for the treatment of pulmonary infections with gram + bacteria in neonates. The concentration of vancomycin in the ELF of neonates exceed the MIC90 of S. epidermidis and S. aureus including MRSA.