Τίτλος:
Pharmacokinetics of teicoplanin in an ICU population of children and infants
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose. Better dosing is needed for antibiotics, including teicoplanin (TEI), to prevent emergence of resistant bacterial strains. Here, we assess the TEI pharmacokinetics (PK) related to a 10 mg/l minimum inhibitory concentration (MIC) target in ICU children (4 to 120 months; n = 20) with gram+ infections. Methods. Standard administration of TEI was with three 10 mg/kg Q12h, loading infusions, and maintainance with 10 mg/kg or 15 mg/kg Q24h. During maintenance, 9 samples (3/day) were collected per patient and the PK analyzed with Nonlinear Mixed Effects Model (NONMEM). Results. Thirty-five percent of concentrations in older children (≥2 months) vs. 8% in younger infants (<12 months) were below the target MIC. The global bicompartmental population PK parameters were [mean (interindividual CV%)] CL = 0.23 l/h [72%], V = 3.16 l [58%], k 12 = 0.23 h-1, and k21 = 0.04 h-1. Two PK subpopulations were identified. The older children had CL = 0.29 [23%] l/h, V = 3.9 l and the younger infants, CL = 0.09 [37%] l/h, V = 1.05 l. Residual error was reduced from 52% to around 30% in the final models. Conclusions. Older children in the ICU may require relatively higher doses of teicoplanin. However, a study in a larger population is needed. © 2004 Springer Science+Business Media, Inc.
Συγγραφείς:
Lukas, J.C.
Karikas, G.
Gazouli, M.
Kalabalikis, P.
Hatzis, T.
Macheras, P.
Περιοδικό:
Pharmaceutical Research
Λέξεις-κλειδιά:
teicoplanin; antiinfective agent; teicoplanin, age distribution; article; bacterial infection; child; clinical article; clinical trial; concentration (parameters); controlled clinical trial; controlled study; drug eruption; error; female; Gram positive bacterium; human; infant; intensive care unit; male; mathematical model; minimum inhibitory concentration; priority journal; randomized controlled trial; standard; aging; algorithm; bacterial infection; body weight; fluorescence polarization immunoassay; intensive care unit; metabolism; microbiology; Monte Carlo method; population; preschool child; Staphylococcus infection; statistical model, Aging; Algorithms; Anti-Bacterial Agents; Body Weight; Child; Child, Preschool; Female; Fluorescence Polarization Immunoassay; Gram-Positive Bacterial Infections; Humans; Infant; Intensive Care Units; Male; Models, Statistical; Monte Carlo Method; Population; Staphylococcal Infections; Teicoplanin
DOI:
10.1023/B:PHAM.0000048198.56873.d8
