Effect of hypothermia treatment on gentamicin pharmacokinetics in neonates with hypoxic-ischaemic encephalopathy: A systematic review and meta-analysis

Choi, D. W.; Park, J. H.; Lee, S. Y.; An, Sook Hee

doi:10.1111/jcpt.12711

Cited by 13 publications

(9 citation statements)

References 39 publications

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“…Amikacin clearance was decreased to 40.6% in these neonates and a 12-h increase in the amikacin dosing interval was proposed to correct for the reduced clearance [133]. A decreased clearance of gentamycin during TH was confirmed by a meta-analysis of eight studies: modified gentamicin dosing regimens with 36-h intervals are required to yield safe and effective exposures [134]. Considering reduced drug clearance, Cies et al suggested that dosing regimens of ampicillins 25-50 mg/kg/day were sufficient to protect against susceptible bacteria in neonates with HIE [135].…”

Section: Tdm and Antiepileptic Drugsmentioning

confidence: 94%

Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age

Rose

Cairoli

Dionisi

et al. 2020

IJMS

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Therapeutic drug monitoring (TDM) should be adopted in all neonatal intensive care units (NICUs), where the most preterm and fragile babies are hospitalized and treated with many drugs, considering that organs and metabolic pathways undergo deep and progressive maturation processes after birth. Different developmental changes are involved in interindividual variability in response to drugs. A crucial point of TDM is the choice of the bioanalytical method and of the sample to use. TDM in neonates is primarily used for antibiotics, antifungals, and antiepileptic drugs in clinical practice. TDM appears to be particularly promising in specific populations: neonates who undergo therapeutic hypothermia or extracorporeal life support, preterm infants, infants who need a tailored dose of anticancer drugs. This review provides an overview of the latest advances in this field, showing options for a personalized therapy in newborns and infants.

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Section: Tdm and Antiepileptic Drugsmentioning

confidence: 94%

Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age

Rose

Cairoli

Dionisi

et al. 2020

IJMS

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“…extraction ratio) characteristics (Pokorna et al, 2015;Zeilmaker et al, 2018). This is also reflected in Table 1, in which a lower gentamicin (Choi et al, 2018) or amikacin (Cristea et al, 2017) clearance is related to TH and/or PA (−31%, −40.6%), with an increase in clearance (+29%) over time (after TH, highly correlated with increasing PNA) (Bijleveld et al, 2016), and weight and/or creatinine as covariates (Frymoyer et al, 2013;Cristea et al, 2017). A similar pattern can be observed for different b-lactam antibiotics (ampicillin, amoxicillin, benzyl-penicillin) with reduced clearance during controlled hypothermia (−66%) (Cies et al, 2017) and a subsequent increase in clearance (+58%) over time (Bijleveld et al, 2018).…”

Section: Knowledge On the Impact Of Hypothermia On Adme Processes In mentioning

confidence: 52%

“…Finally, hypothermia reduces renal drug excretion. For drugs eliminated by glomerular filtration rate (GFR) in neonates with PA and TH, studies consistently showed that elimination is significantly (−30 up to −40%) reduced, with an increase after finalization of the TH (> 72h) (Mark et al, 2013;Ting et al, 2015;Bijleveld et al, 2016;Cristea et al, 2017;Choi et al, 2018). A similar pattern can be observed for the different b-lactam antibiotics (ampicillin, amoxicillin, benzyl-penicillin).…”

Section: Knowledge On the Impact Of Hypothermia On Adme Processes In mentioning

confidence: 66%

A Physiology-Based Pharmacokinetic Framework to Support Drug Development and Dose Precision During Therapeutic Hypothermia in Neonates

et al. 2020

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“…14,[23][24][25][26][27][28] A recent metaanalysis reported that CL of gentamicin was reduced during TH. 29 In this study, they have summarized the results from the published studies and reported reduced CL of gentamicin during TH. They focused on the combined impact of PA and TH.…”

Section: Discussionmentioning

confidence: 99%

Pharmacometric approach to assist dosage regimen design in neonates undergoing therapeutic hypothermia

Matcha

Raj

Mahadevan³

et al. 2021

Pediatr Res

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Background Therapeutic hypothermia (TH) is the treatment of choice for neonates diagnosed with perinatal asphyxia (PA). Dosing recommendations of various therapeutic agents including antimicrobials were not specifically available for the neonates undergoing TH. Methods A systematic search methodology was used to identify pharmacokinetic (PK) studies of antimicrobials during TH. Antimicrobials with multiple PK studies were identified to create a generalizable PK model. Pharmacometric simulations were performed using the PUMAS software platform to reproduce the results of published studies. A suitable model that could reproduce the results of all other published studies was identified. With the help of a generalizable model, an optimal dosage regimen was designed considering the important covariates of the identified model. Results With the systematic search, only gentamicin had multiple PK reports during TH. A generalizable model was identified and the model predictions could match the reported/observed concentrations of publications. Birth weight and serum creatinine were the significant covariates influencing the PK of gentamicin in neonates. A dosage nomogram was designed using pharmacometric simulations to maintain gentamicin concentrations below 10 μg/mL at peak and below 2 μg/mL at trough. Conclusions A generalizable PK model for gentamicin during TH in neonates was identified. Using the model, a dosing nomogram for gentamicin was designed. Impact Dosing guidelines for antimicrobials during TH in neonates is lacking. This is the first study to identify the generalizable model for gentamicin during TH in neonates. Nomogram, proposed in the study, will aid the clinicians to individualize gentamicin dosing regimen for neonates considering the birth weight and serum creatinine.

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Effect of hypothermia treatment on gentamicin pharmacokinetics in neonates with hypoxic-ischaemic encephalopathy: A systematic review and meta-analysis

Abstract: Gentamicin clearance is decreased in neonates with HIE receiving hypothermia treatment compared to those not receiving hypothermia treatment. Modified gentamicin dosing regimens are required to avoid potential toxicity related to higher concentrations during hypothermia treatment.

Cited by 13 publications

References 39 publications

Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age

Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age

A Physiology-Based Pharmacokinetic Framework to Support Drug Development and Dose Precision During Therapeutic Hypothermia in Neonates

Pharmacometric approach to assist dosage regimen design in neonates undergoing therapeutic hypothermia

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