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Original Article

Korean J Physiol Pharmacol 2024; 28(2): 121-127

Published online March 1, 2024

Copyright © Korean J Physiol Pharmacol.

Development of a model to predict vancomycin serum concentration during continuous infusion of vancomycin in critically ill pediatric patients

Yu Jin Han1,#, Wonjin Jang2,#, Jung Sun Kim3, Hyun Jeong Kim1, Sung Yun Suh1, Yoon Sook Cho1, June Dong Park2, and Bongjin Lee2,4,*

1Department of Pharmacy, Seoul National University Hospital, 2Department of Pediatrics, Seoul National University Hospital and College of Medicine, Seoul 03080, 3College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, 4Innovative Medical Technology Research Institute, Seoul National University Hospital, Seoul 03080, Korea

Correspondence to:Bongjin Lee

#These authors contributed equally to this work.

Author contributions: Y.J.H., B.L., and J.D.P. conceived and designed the study. Primary investigation on the subject matter was done by Y.J.H., J.S.K., and S.Y.S. Acquisition and analysis of the data were done by Y.J.H., H.J.K., and Y.S.C. The drafting of the manuscript was done by Y.J.H. and W.J. Revision of the manuscript was done by B.L.

Received: November 2, 2023; Revised: January 11, 2024; Accepted: January 15, 2024


Vancomycin is a frequently used antibiotic in intensive care units, and the patient’s renal clearance affects the pharmacokinetic characteristics of vancomycin. Several advantages have been reported for vancomycin continuous intravenous infusion, but studies on continuous dosing regimens based on patients’ renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient’s renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin administration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomycin serum concentration. Vancomycin serum concentration was affected by vancomycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = –1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R2 = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regimen for vancomycin.

Keywords: Intravenous infusions, Pediatric intensive care units, Pharmacokinetics, Vancomycin