Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data

. The RCH data set included 3,687 vancomycin concentrations from 627 children. A two-compartment model with renal maturation best described the data. External validation (PCH 175, SCH 58, and CHW 170 concentrations) showed adequate predictive performance. The optimized dosing strategy achieved a target attainment of 73% versus 44% with the standard 15 mg/kg of body weight administered every 6 h. Improvement was most notable in patients <4 years, where the probability of target attainment (PTA) increased from 10.5%-48% to 66.1%-80% with the optimized regimen. A 25 mg/kg loading dose significantly increased the initial 24-h PTA to 57%, compared to 23% without a loading dose. We developed an optimized vancomycin dosing strategy that achieved the therapeutic target in 73% of children. This regimen requires prospective clinical validation.

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Publication Details

Journal
Antimicrobial Agents and Chemotherapy
Published
2026-05-12
DOI
https://doi.org/10.1128/aac.01840-25
Primary Topic
Antimicrobial Resistance in Staphylococcus
Type
article
Field-Weighted Citation Impact
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article

Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data

Amanda Gwee, Haiping Xu, Xiao Zhu, Wenyu Yang et al.
Antimicrobial Agents and Chemotherapy
Antimicrobial Resistance in Staphylococcus
article

Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data

Amanda Gwee, Haiping Xu, Xiao Zhu, Wenyu Yang, Amanda Wilkins, Zoy Goff, Brendan McMullan, Daniel Yeoh, Tony Lai
article en

Abstract

. The RCH data set included 3,687 vancomycin concentrations from 627 children. A two-compartment model with renal maturation best described the data. External validation (PCH 175, SCH 58, and CHW 170 concentrations) showed adequate predictive performance. The optimized dosing strategy achieved a target attainment of 73% versus 44% with the standard 15 mg/kg of body weight administered every 6 h. Improvement was most notable in patients <4 years, where the probability of target attainment (PTA) increased from 10.5%-48% to 66.1%-80% with the optimized regimen. A 25 mg/kg loading dose significantly increased the initial 24-h PTA to 57%, compared to 23% without a loading dose. We developed an optimized vancomycin dosing strategy that achieved the therapeutic target in 73% of children. This regimen requires prospective clinical validation.

Antimicrobial Agents and Chemotherapy
The University of Sydney (AU), Royal Children's Hospital (AU), The University of Melbourne (AU), The Kids Research Institute Australia (AU), The University of Western Australia (AU), American Association of Colleges of Pharmacy (US), Princess Margaret Hospital for Children (AU), Taronga Conservation Society Australia (AU), Children's Hospital at Westmead (AU), UNSW Sydney (AU), Sydney Children's Hospital (AU), Pharmaceutical Formulations (United States) (US), Murdoch Children's Research Institute (AU), Perth Children's Hospital
Good health and well-being
Openalex Percentile: Top 5%
Antimicrobial Resistance in Staphylococcus
DOIOpen Access PDFOpenAlex
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Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data — Amanda Gwee, Haiping Xu, et al. · Antimicrobial Agents and Chemotherapy (2026) | TGRS Research Map | TGRS