Abstract

Aims & Objectives: Vancomycin is widely used in PICU The relationship between Plasma Trough Concentrations (PTC) with effectiveness and safety is crucial. Area Under the Curve (AUC) >400 (mcg *h/mL) and < 600 (mcg *h/mL) is related to better therapeutic results.Our objetive was to compare initiation dose of vancomycin: 40 mg / kg / day (A) versus 60 mg / kg / day (B). Methods: Prospective cohort study, we included all patients that received vancomycin at the PICU in 2018 for at least 48 hours with PTC, AUC measurement, randomizing to A or B doses. Patients were excluded if they were in kidney failure. Results: We included 85 cases (75 patients), 48 cases in group A and 37 in group B, B. Patients who started dose A had lower AUC average than those who started dose B, with AUC of 378 ± 260 vs 490 ± 187 (p = 0.0293), this group (B) shows a higher proportion of AUC > 400 (mcg *h/mL) (RR = 2.4, p = 0.0002). AUC> 600 (mcg *h/mL) was obtained in 13% of A and 24% of B group (p = 0.2506). Increase of Cr> 25% in 5/48 (A) and 5/37 (B), respectively (p = 0.7410). Conclusions: A initial vancomycin dose of 60 mg / kg / day in pediatric critical patients without kidney failure is more efficient in obtaining PTC in therapeutic range than one of 40 mg / kg / day. No differences were found in kidney impairment events.