The efficacy of a vancomycin loading dose with more frequent dosing and shorter duration of treatment was comparable to standard dosing regimens for gram-positive sepsis in infants but with heightened risk for impaired hearing, in the largest neonatal vancomycin efficacy trial to date.

The investigated dosing regimen was derived from preclinical studies conducted in the NeoVanc project, a European collaborative coordinated by Penta, an international independent research network focusing on child health, which also conducted this phase 2b open-label clinical trial.

These pre-trial studies demonstrated more efficient reduction in C-reactive protein, particularly in infants younger than 29 weeks postmenstrual age.

The use of a loading dose to initiate the more frequently dosed but shorter regimen was drawn, in part, from guidelines from the Infectious Diseases Society of America guideline for treating methicillin-resistant staphyloccoccus aureus.

The investigators note, however, their study could be the first to investigate the utility of a loading dose with intermittent dosing for neonatal sepsis.

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