da Silva Alves GC, et al. – In this meta–analysis, the physicians aimed to determine the initial dose of vancomycin which was required to achieve the therapeutic target in pediatrics. They disclosed that doses lower than 60 mg/kg/day were not enough to achieve desirable vancomycin plasma concentrations “area under the curve in 24 h/minimum inhibitory concentration >400 (AUC_0–24/MIC>400) or trough 10–20 mg/L” to control bacterial infections in pediatrics.

Methods

• The search was conducted in the following data sources: Pubmed (1980–2017), the Cochrane Library, and Embase (1986–2017) and the references of the published studies; searches were performed using the key terms: child, children, pediatrics, infants and adolescents, vancomycin, pharmacokinetics, and pharmacodynamics.
• With the aid of RevMan V 5.2 software, the data extracted from the studies were analyzed and grouped.
• Considering the Mantel–Haenszel random effect, the confidence interval (CI) 95% and the odds ratio (OR) were calculated.

Results

• From the 704 studies identified, 40 revealed eligibility for this review and only 20 presented enough data to be included in the statistical analysis.
• The articles found in this review were published between 1980 and 2017.
• The vancomycin doses varied between 40 mg/kg/day to 120 mg/kg/day. 
• The statistical tests displayed significant clinical heterogeneity of I² (84%).