Abstract
Vancomycin is frequently prescribed in pediatrics, especially in intensive care unit settings, to treat Gram-positive bacterial infections. This work aims to collect the top-cited articles of pediatric and infectious diseases areas to gather the current evidence and gaps of knowledge on the use of vancomycin in these populations. The most relevant journals reported in the “pediatrics” and “infectious diseases” categories of the 2019 edition of Journal Citation Reports were browsed. Articles with more than 30 citations and published over the last three decades were collected. A bibliometric analysis was performed and 115 articles were retrieved. They were published in 21 journals, with a median impact factor of 4.6 (IQR 2.9–5.4). Sixty-eight of them (59.1%) belonged to “infectious diseases” journals. The most relevant topic was “bloodstream/complicated/invasive infections”, followed by “antibiotic resistance/MRSA treatment”. As for population distribution, 27 articles were on children only and 27 on neonates, most of which were from intensive care unit (ICU) settings. The current literature mainly deals with vancomycin as a treatment for severe infections and antibiotic resistance, especially in neonatal ICU settings. Lately, attention to new dosing strategies in the neonatal and pediatric population has become a sensible topic.
Highlights
Vancomycin is one of the most frequently prescribed glycopeptides, especially in children and newborns in intensive care unit (ICU) settings for the treatment of Grampositive bacterial infections by coagulase-negative Staphylococci (CoNS), Enterococci spp, methicillin-resistant Staphylococcus aureus (MRSA), and C. difficile
All the journals of the first quartile belonging to the “pediatrics” and “infectious diseases” categories were considered in order to include those with the highest impact factor (IF)
One hundred and fifteen top-cited articles were retrieved in total, published in 21/55 journals, with a median IF of 4.6 (IQR 2.9–5.4)
Summary
Vancomycin is one of the most frequently prescribed glycopeptides, especially in children and newborns in intensive care unit (ICU) settings for the treatment of Grampositive bacterial infections by coagulase-negative Staphylococci (CoNS), Enterococci spp, methicillin-resistant Staphylococcus aureus (MRSA), and C. difficile. It inhibits cell wall synthesis by binding to the D-Ala-D-Ala terminal of the peptide chain and has a volume of distribution of 0.4–1 L/kg [1]. Based on these pharmacodynamics data, continuous infusion of vancomycin has been proposed for severe infections, guaranteeing higher steady-state concentrations. There is little consensus on choosing the optimal dosing regimen and administration schedule (intermittent vs. continuous infusion) in children and even more in neonates, especially in preterm and extremely preterm patients
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