Characterization of Vancomycin Reactions and Linezolid Utilization in the Pediatric Population

Lin, Shih‐Chun; Mulieri, Kevin M.; Ishmael, Faoud T.

doi:10.1016/j.jaip.2016.12.022

Cited by 13 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Being a post-hoc analysis a formal sample size was not conducted. Even if similar experiences 19–25 have been reported with smallest samples, these conclusions should be confirmed by other reports or larger samples. First, this study has been planned in a population receiving a prophylaxis with vancomycin and cefoxitin.…”

Section: Discussionsupporting

confidence: 70%

“…In the studied population we did not record any intraoperative drug related adverse event, even if this may be due to the relatively short study duration. We acknowledge that reversible vancomycin related hypotension has been occasionally experienced in past years by our group at anesthesia induction, 23,24 but this was not the case in the studied patients.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Vancomycin concentrations during cardiopulmonary bypass in pediatric cardiac surgery: a prospective study

et al. 2021

View full text Add to dashboard Cite

Introduction: Few data are available regarding intraoperative plasma concentrations of vancomycin administered as prophylaxis in pediatric cardiac surgery. The aims of this study were to investigate during pediatric cardiac surgery with cardiopulmonary bypass(CPB) the attainment of the area-under-the-curve of the vancomycin serum concentrations versus time over surgery to minimum inhibitory concentration ratio(AUCintra/MIC) of 400 (mg × h)/l and/or a target concentration of 15–20 mg/l. Methods: In a prospective study, 40 patients divided into four subgroups (neonates, infants, children <10 years-old, ⩾10 years-old) undergoing cardiac surgery with cardiopulmonary bypass (CPB) were enrolled. A slow vancomycin bolus of 20 mg/kg, up to a maximum dose of 1000 mg was administered before skin incision and a further dose of 10 mg/kg (up to 500 mg) at CPB start. Vancomycin samples were collected intraoperatively at four time points. Results: The median (interquartile range) age was 241.5 days (47–3898) and the median weight was 7.1 kg (3.1–37). The median AUCintra/MIC was 254.73 (165.89–508.06). In 11 patients the AUCintra/MIC target was not reached. Neonates displayed the lowest AUCintra/MIC values, and these were significantly lower than those of children ⩾10 years old (p = 0.02). Vancomycin concentrations were above the maximal target of 20 mg/l in 82.5% and 80% of patients at surgery and CPB start, respectively. At CPB and surgery end, 42.5% of patients showed vancomycin concentrations above 20 mg/l and 42.5% below 15 mg/l. Patients⩾10 years old showed the highest peak values whereas neonates were those with the lowest troughs. AUCintra/MIC correlated with age(r:0.36, p = 0.02), weight(r:0.35, p = 0.03), intraoperative protein value(r:0.40, p = 0.01), CPB priming volume/kg(r:−0.33, p = 0.04), CPB duration(r:0.36, p = 0.02) and vancomycin troughs(r:0.35, p = 0.04). Conclusions: An AUCintra/MIC ⩾400 target was not reached in one-quarter of children undergoing heart surgery. Vancomycin peaked before the start of surgery and neonates were those with the lowest troughs. Vancomycin concentrations are affected by CPB hemodilution and by patients’ age and weight.

show abstract

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 67%

Vancomycin concentrations during cardiopulmonary bypass in pediatric cardiac surgery: a prospective study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Although the incidence of rash ranked third among the specific events in our study, it was almost five times lower than that with vancomycin [ 11 ]. Studies estimate that 1.6%–14% of children have vancomycin reactions that lead to histamine release, which might have resulted in the discontinuation of the medication [ 20 ]. In the current study, linezolid appeared to be safer in terms of rash events.…”

Section: Discussionmentioning

confidence: 99%

Safety and clinical efficacy of linezolid in children: a systematic review and meta-analysis

Shi

et al. 2022

World J Pediatr

View full text Add to dashboard Cite

Background We aimed to evaluate the tolerability and efficacy of linezolid in children for treating suspected and diagnosed Gram-positive bacterial infections. Methods A systematic literature search was conducted up to April 23, 2021, using linezolid and its synonyms as search terms. Two reviewers independently identified and extracted relevant randomized controlled trials and prospective cohort studies. The extracted studies were included in a single-rate meta-analysis of adverse events and clinical outcomes using random-effects models. Results A total of 1082 articles were identified, and nine studies involving 758 children were included in the meta-analysis. The overall proportion of adverse events was 8.91% [95% confidence interval (CI) = 1.64%–36.52%], with diarrhea (2.24%), vomiting (2.05%), and rash (1.72%) being the most common. The incidences of thrombocytopenia and anemia were 0.68% and 0.16%, respectively. Some specific adverse events, including rash and gastrointestinal events, were more frequent in the oral administration subgroup. In terms of efficacy, the overall proportion of clinical improvement was 88.80% (95% CI = 81.31%–93.52%). Children with a history of specific bacteriological diagnosis or concomitant antibiotic therapy had a 1.13-fold higher clinical improvement than children without such histories. The proportion of microbial eradication was 92.68% (95% CI = 84.66%–96.68%). The proportion of all-cause mortality was 0.16% (95% CI = 0.00%–7.75%). Conclusions Linezolid was well-tolerated in pediatric patients and was associated with a low frequency of adverse events, such as anemia, thrombocytopenia, and neutropenia. Moreover, linezolid was effective in children with diagnosed and suspected Gram-positive infections.

show abstract

“…Anahtar Kelimeler: Penisiline dirençli pnömokok, menenjit, vankomisin, yan etki, red neck sendromu, tedavi yönetimi (11,14). Sunduğumuz olguda da vankomisin tedavisi kesilip, alternatif antibiyotik olan linezolid tedavisine geçildi.…”

Section: Penicillin Resistantunclassified

“…Glikopeptid grubunda yer alan teikoplaninin vankomisinden daha hızlı infüzyonla uygulandığında bile histamin salınımına ve bununla ilişkili semptomlara neden olmadığı bildirilmiştir. Bu nedenle vankomisine bağlı olarak RNS gelişen hastalarda alternatif antibiyotikler teikoplanin ve linezoliddir (11,14). Sunduğumuz olguda da vankomisin tedavisi kesilip, alternatif antibiyotik olan linezolid tedavisine geçildi.…”

unclassified

Vankomisin tedavisine bağlı olarak red neck sendromu gelişen penisiline dirençli pnömokok menenjiti olgusu

Esmer

Cesur

Hatipoğlu

et al. 2019

Journal of Health Sciences and Medicine

View full text Add to dashboard Cite

Red neck syndrome which is a side effect of vancomycin, is associated with excessive release of histamine and is sometimes a life threatening complication. In patients who develop red neck syndrome, if necessary, vancomycin therapy may be continued with corticosteroids and antihistamines or an alternative antibiotic may be started. In this report, a 54 year-old female patient who was started vancomycin therapy because of penicillin resistant pneumococcal meningitis and developed red neck syndrome on 8th day of the therapy was presented. It was learned that the patient's vancomycin infusion that morning was shorter than one hour. Vancomycin therapy was stopped and intravenous linezolide was started. In conclusion, red neck syndrome may develop due to rapid infusion of vancomycin. In this patients linezolide may be used as alternative therapy.

show abstract

Characterization of Vancomycin Reactions and Linezolid Utilization in the Pediatric Population

Cited by 13 publications

References 30 publications

Vancomycin concentrations during cardiopulmonary bypass in pediatric cardiac surgery: a prospective study

Vancomycin concentrations during cardiopulmonary bypass in pediatric cardiac surgery: a prospective study

Safety and clinical efficacy of linezolid in children: a systematic review and meta-analysis

Vankomisin tedavisine bağlı olarak red neck sendromu gelişen penisiline dirençli pnömokok menenjiti olgusu

Contact Info

Product

Resources

About