Effect of Severity Disease on the Pharmacokinetics of Cefuroxime in Children with Multiple Organ System Failure

Olguı́n, Hugo Juárez; Asseff, Ismael Lares; Vieyra, Angélica Camacho; Pérez, Alejandro Escánez; Saldaña, Napoleón González; Quesada, Argelia Camarillo; Guillé, Gabriela Pérez

doi:10.1248/bpb.31.316

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…Therefore, the identification of these concentrations is of paramount importance if we want to get the maximum therapeutic benefit. The results of the present study suggest a modification in the treatment regimens in Neonatology service of General Hospital of Durango, Mexico, as was recommended in previous studies [27, 28]. …”

Section: Discussionsupporting

confidence: 69%

Pharmacokinetics of ranitidine in preterm and term neonates with gastroesophageal reflux

Asseff

Gaucin²,

Olguı́n

et al. 2016

BMC Pediatr

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BackgroundThe aim of this study was to determine the effect of gestational age on pharmacokinetics of ranitidine in newborns with gastroesophageal reflux.MethodsA prospective, descriptive and pharmacokinetic study was carried out in 30 pre-term and 20 full-term babies. 3 mg/kg of ranitidine was administered intravenously to all the babies and at 0.25, 0.5, 1, 2, 4, and 8 h following the administration, samples of blood were drawn to assess ranitidine levels using high performance liquid chromatographic technique.ResultsPharmacokinetics of ranitidine had a bi-exponential behavior with a half-life elimination of (t1/2el) 2.79 h, area under curve (AUC) of 1688 ng/mL, volume of distribution (Vd) of 1.44 L/kg, and clearance (Cl) of 5.9 L/kg/h. The median plasmatic concentration in pre-terms was 1113 ng/mL and 280 ng/mL in full-terms. Vd, t1/2 and Cl presented high values in preterm although the correlation of Cl with glomerular filtration in term newborns was better.ConclusionsPlasma levels of ranitidine depend on the gestational age of the newborns. However, the possible relationship between after-birth age and pharmacokinetics of the neonates as their internal organs get matured without minding their gestational background.

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Section: Discussionsupporting

confidence: 69%

Pharmacokinetics of ranitidine in preterm and term neonates with gastroesophageal reflux

Asseff

Gaucin²,

Olguı́n

et al. 2016

BMC Pediatr

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“…We identified only one study on cefuroxime PK in PICU patients [30], 15 patients in total, including 4 non-critically ill patients with pharyngitis. The 11 PICU patients were divided in 2 groups: a severely ill group of 5 PICU patients not requiring mechanical ventilation, and a very severely ill group with 6 patients requiring mechanical ventilation.…”

Section: Cefuroximementioning

confidence: 99%

Pharmacokinetics and Target Attainment of Antibiotics in Critically Ill Children: A Systematic Review of Current Literature

et al. 2019

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Background Pharmacokinetics (PK) are severely altered in critically ill patients due to changes in volume of distribution (Vd) and/or drug clearance (Cl). This affects the target attainment of antibiotics in critically ill children. We aimed to identify gaps in current knowledge and to compare published PK parameters and target attainment of antibiotics in critically ill children to healthy children and critically ill adults. Methods Systematic literature search in PubMed, EMBASE and Web of Science. Articles were labelled as relevant when they included information on PK of antibiotics in critically ill, non-neonatal, pediatric patients. Extracted PK-parameters included Vd, Cl, (trough) concentrations, AUC, probability of target attainment, and elimination half-life. Results 50 relevant articles were identified. Studies focusing on vancomycin were most prevalent (17/50). Other studies included data on penicillins, cephalosporins, carbapenems and aminoglycosides, but data on ceftriaxone, ceftazidime, penicillin and metronidazole could not be found. Critically ill children generally show a higher Cl and larger Vd than healthy children and critically ill adults. Reduced target-attainment was described in critically ill children for multiple antibiotics, including amoxicillin, piperacillin, cefotaxime, vancomycin, gentamicin, teicoplanin, amikacin and daptomycin. 38/50 articles included information on both Vd and Cl, but a dosing advice was given in only 22 articles. Conclusion The majority of studies focus on agents where TDM is applied, while other antibiotics lack data altogether. The larger Vd and higher Cl in critically ill children might warrant a higher dose or extended infusions of antibiotics in this patient population to increase target-attainment. Studies frequently fail to provide a dosing advice for this patient population, even if the necessary information is available. Our study shows gaps in current knowledge and encourages future researchers to provide dosing advice for special populations whenever possible.

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“…A total of twenty studies were reported among pediatrics ( Table 1 ). Of 20 studies, eight studies were reported on penicillins ( Cies et al, 2014 ; De Cock et al, 2015 ; Nichols et al, 2016 ; De Cock et al, 2017 ; Béranger et al, 2019 ; Tang et al, 2019 ; D’Agate et al, 2020 ; Wu et al, 2021 ), eight on cephalosporins ( Olguin et al, 2008 ; Fukumoto et al, 2009 ; De Cock et al, 2016 ; Cies et al, 2018a ; Béranger et al, 2018 ; Cies et al, 2019 ; Hartman et al, 2019 ) and 4 on carbapenems ( Giannoni et al, 2006 ; Cies et al, 2015 ; Cies et al, 2017b ; Tan et al, 2018 ) ( Table 1 ). Four studies were reported on amoxicillin ( De Cock et al, 2015 ; Tang et al, 2019 ; D’Agate et al, 2020 ; Wu et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

“…The recommended dose of cefotaxime ranges from 100 mg to 300 mg/kg as a continuous infusion that achieved 100% probability target attainment (PTA). Olguin et al (2008) studied the PK parameters of cefuroxime on 11 patients with septicemia and septic shock. The authors recommended the dose of 100 mg/kg of body weight, administered every 6 h by intravenous infusion for 30 min.…”

Section: Resultsmentioning

confidence: 99%

Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review

et al. 2022

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Background: β-lactams remain the cornerstone of the empirical therapy to treat various bacterial infections. This systematic review aimed to analyze the data describing the dosing regimen of β-lactams.Methods: Systematic scientific and grey literature was performed in accordance with Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The studies were retrieved and screened on the basis of pre-defined exclusion and inclusion criteria. The cohort studies, randomized controlled trials (RCT) and case reports that reported the dosing schedule of β-lactams are included in this study.Results: A total of 52 studies met the inclusion criteria, of which 40 were cohort studies, 2 were case reports and 10 were RCTs. The majority of the studies (34/52) studied the pharmacokinetic (PK) parameters of a drug. A total of 20 studies proposed dosing schedule in pediatrics while 32 studies proposed dosing regimen among adults. Piperacillin (12/52) and Meropenem (11/52) were the most commonly used β-lactams used in hospitalized patients. As per available evidence, continuous infusion is considered as the most appropriate mode of administration to optimize the safety and efficacy of the treatment and improve the clinical outcomes.Conclusion: Appropriate antibiotic therapy is challenging due to pathophysiological changes among different age groups. The optimization of pharmacokinetic/pharmacodynamic parameters is useful to support alternative dosing regimens such as an increase in dosing interval, continuous infusion, and increased bolus doses.

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Effect of Severity Disease on the Pharmacokinetics of Cefuroxime in Children with Multiple Organ System Failure

Cited by 8 publications

References 21 publications

Pharmacokinetics of ranitidine in preterm and term neonates with gastroesophageal reflux

Pharmacokinetics of ranitidine in preterm and term neonates with gastroesophageal reflux

Pharmacokinetics and Target Attainment of Antibiotics in Critically Ill Children: A Systematic Review of Current Literature

Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review

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