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Continuous infusion of vancomycin in neonates
  1. Anisa D Patel1,2,
  2. Dhullipala Anand1,
  3. Carol Lucas3,
  4. Alison H Thomson4,5
  1. 1Neonatal Intensive Care Unit, Royal Hospital for Sick Children, Glasgow, UK
  2. 2Pharmacy Department, Royal Hospital for Sick Children, Glasgow, UK
  3. 3Department of Clinical Microbiology, Royal Hospital for Sick Children, Glasgow, UK
  4. 4Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
  5. 5Pharmacy Department, Western Infirmary, Glasgow, UK
  1. Correspondence to Anisa D Patel, Pharmacy Department, Royal Hospital for Sick Children Yorkhill Hospital, Dalnair Street, Glasgow G3 8SJ, UK; anisa.patel{at}ggc.scot.nhs.uk

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A one year, retrospective audit of intermittent vancomycin therapy within the Neonatal Unit at the Royal Hospital for Sick Children, Glasgow, found that only 33% of 984 vancomycin trough levels were within the British National Formulary for children (BNFc) target range of 10–15 mg/l and 25% were <10 mg/l. A detailed, prospective review of 20 courses (15 patients) over one month, while using the same dosing guidelines, highlighted that only 23 of 50 concentration measurements (46%) were within the target range and 20% were <10 mg/l, even though the initial doses used (table 1) were higher than those recommended by the BNFc. Dose adjustments were common and up to 80 mg/kg/day was often required for older infants. Appropriate interpretation of concentration results was compromised …

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