Impact of Extracorporeal Membrane Oxygenation in an Infant Treated with Vancomycin: A Case Report

Chihiro Shiraishi, Hideo Kato (), Hiroshi Imai and Takuya Iwamoto
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Chihiro Shiraishi: Department of Pharmacy, Mie University Hospital, Tsu 514-8507, Japan
Hideo Kato: Department of Pharmacy, Mie University Hospital, Tsu 514-8507, Japan
Hiroshi Imai: Emergency and Critical Care Center, Mie University Hospital, Tsu 514-8507, Japan
Takuya Iwamoto: Department of Pharmacy, Mie University Hospital, Tsu 514-8507, Japan

IJERPH, 2023, vol. 20, issue 3, 1-7

Abstract: Vancomycin is a glycopeptide antibiotic used for prophylaxis and treatment of infections caused by methicillin-resistant Staphylococcus aureus. Although major organ sizes and functions mature during infancy, pharmacokinetic studies, especially those focused on infants, are limited. Changes in extracorporeal membrane oxygenation-related drug disposition largely contribute to changes in pharmacokinetics. Here, pharmacokinetic profiles of vancomycin in an infant receiving extracorporeal membrane oxygenation therapy are presented. A two-month-old Japanese infant with moderately decreased renal function was started on 12.0 mg/kg vancomycin every 8 h from day X for prophylaxis of pneumonia during extracorporeal membrane oxygenation therapy. As the trough concentration of vancomycin observed on day X+3 was 27.1 ?g/mL, vancomycin was then discontinued. The trough concentration decreased to 18.6 ?g/mL 24 h after discontinuation, and 9.0 mg/kg vancomycin every 12 h was restarted from day X+5. On day X+6, the trough concentration increased to 36.1 ?g/mL, and vancomycin therapy was again discontinued. On day X+7, the trough concentration decreased to 22.4 ?g/mL. The pharmacokinetic profiles of vancomycin based on first-order conditional estimation in this infant were as follows: plasma clearance = 0.053 L/kg/hour, distribution volume = 2.19 L/kg, and half-life = 29.5 h. This research reported the prolonged half-life of vancomycin during extracorporeal membrane oxygenation in infants with moderately decreased renal function.

Keywords: infant; vancomycin; pharmacokinetic; pharmacodynamic; extracorporeal membrane oxygenation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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