Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients
Background: Meropenem is a widely used carbapenem for treating severe pediatric infections. However, few studies have assessed its pharmacokinetics/pharmacodynamics (PK/PD) in pediatric patients. This study aimed to evaluate the proportion of Saudi pediatric patients achieving the PK/PD target of me...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-07-01
|
| Series: | Pediatrics and Neonatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957223002450 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849763840493879296 |
|---|---|
| author | Abdullah Alsultan Maram R. Aldawsari Nujood Khaled Alturaiq Saeed Ali Syed Abdulaziz Alsubai Zeyad Kurdee Sarah Alsubaie Saeed Alqahtani Manal Abouelkheir |
| author_facet | Abdullah Alsultan Maram R. Aldawsari Nujood Khaled Alturaiq Saeed Ali Syed Abdulaziz Alsubai Zeyad Kurdee Sarah Alsubaie Saeed Alqahtani Manal Abouelkheir |
| author_sort | Abdullah Alsultan |
| collection | DOAJ |
| description | Background: Meropenem is a widely used carbapenem for treating severe pediatric infections. However, few studies have assessed its pharmacokinetics/pharmacodynamics (PK/PD) in pediatric patients. This study aimed to evaluate the proportion of Saudi pediatric patients achieving the PK/PD target of meropenem. Methods: A prospective observational study was conducted at King Saud University Medical City from July to September 2022. Pediatric patients receiving meropenem for suspected or proven infections were included in the study. The primary outcome was the percentage of patients achieving the recommended PK/PD target for critically ill or non-critically ill pediatric patients. Results: The study included 30 patients (nine neonates and 21 older pediatric patients). All neonates were critically ill. Among them, 55 % achieved the PK/PD target of 100 % free time above the MIC. In older ICU pediatric patients, only 11 % attained this target, whereas 58 % of older pediatrics in the general wards achieved the PK/PD target of 50 % free time above the MIC. Augmented renal clearance (ARC) was identified in 57 % of our pediatric patient population, none of whom achieved the recommended PK/PD targets. The median trough concentrations in patients with and without ARC were 0.75 and 1.3 μg/mL, respectively (P < 0.05). Conclusions: The majority of patients in our cohort did not achieve the PK/PD target for meropenem. ARC emerged as a major risk factor for target attainment failure in both critically ill and non-critically ill pediatric patients. |
| format | Article |
| id | doaj-art-c06eabdb58ae4c50bc6ced2e81a00195 |
| institution | DOAJ |
| issn | 1875-9572 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-c06eabdb58ae4c50bc6ced2e81a001952025-08-20T03:05:17ZengElsevierPediatrics and Neonatology1875-95722024-07-0165438639010.1016/j.pedneo.2023.09.008Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patientsAbdullah Alsultan0Maram R. Aldawsari1Nujood Khaled Alturaiq2Saeed Ali Syed3Abdulaziz Alsubai4Zeyad Kurdee5Sarah Alsubaie6Saeed Alqahtani7Manal Abouelkheir8Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Clinical Pharmacokinetics and Pharmacodynamics Unit, King Saud University Medical City, Riyadh, Saudi Arabia; Corresponding author. King Saud University, P. O. Box 2457, Riyadh, 11451, Saudi Arabia.Department of Pharmacy, King Saud University Medical City, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaDepartment of Pharmaceutical, Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Clinical Pharmacokinetics and Pharmacodynamics Unit, King Saud University Medical City, Riyadh, Saudi ArabiaClinical Biochemistry Unit, Department of Pathology, College of Medicine, King Saud University, Saudi ArabiaPediatric Infectious Disease Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Clinical Pharmacokinetics and Pharmacodynamics Unit, King Saud University Medical City, Riyadh, Saudi ArabiaDepartment of Clinical Pharmacy, Faculty of Pharmacy, Misr International University, Cairo, Egypt; Corresponding author. Misr International University, P.O. Box 1, Heliopolis, Cairo, Egypt.Background: Meropenem is a widely used carbapenem for treating severe pediatric infections. However, few studies have assessed its pharmacokinetics/pharmacodynamics (PK/PD) in pediatric patients. This study aimed to evaluate the proportion of Saudi pediatric patients achieving the PK/PD target of meropenem. Methods: A prospective observational study was conducted at King Saud University Medical City from July to September 2022. Pediatric patients receiving meropenem for suspected or proven infections were included in the study. The primary outcome was the percentage of patients achieving the recommended PK/PD target for critically ill or non-critically ill pediatric patients. Results: The study included 30 patients (nine neonates and 21 older pediatric patients). All neonates were critically ill. Among them, 55 % achieved the PK/PD target of 100 % free time above the MIC. In older ICU pediatric patients, only 11 % attained this target, whereas 58 % of older pediatrics in the general wards achieved the PK/PD target of 50 % free time above the MIC. Augmented renal clearance (ARC) was identified in 57 % of our pediatric patient population, none of whom achieved the recommended PK/PD targets. The median trough concentrations in patients with and without ARC were 0.75 and 1.3 μg/mL, respectively (P < 0.05). Conclusions: The majority of patients in our cohort did not achieve the PK/PD target for meropenem. ARC emerged as a major risk factor for target attainment failure in both critically ill and non-critically ill pediatric patients.http://www.sciencedirect.com/science/article/pii/S1875957223002450 |
| spellingShingle | Abdullah Alsultan Maram R. Aldawsari Nujood Khaled Alturaiq Saeed Ali Syed Abdulaziz Alsubai Zeyad Kurdee Sarah Alsubaie Saeed Alqahtani Manal Abouelkheir Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients Pediatrics and Neonatology |
| title | Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| title_full | Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| title_fullStr | Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| title_full_unstemmed | Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| title_short | Evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| title_sort | evaluation of pharmacokinetic pharmacodynamic target attainment of meropenem in pediatric patients |
| url | http://www.sciencedirect.com/science/article/pii/S1875957223002450 |
| work_keys_str_mv | AT abdullahalsultan evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT maramraldawsari evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT nujoodkhaledalturaiq evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT saeedalisyed evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT abdulazizalsubai evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT zeyadkurdee evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT sarahalsubaie evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT saeedalqahtani evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients AT manalabouelkheir evaluationofpharmacokineticpharmacodynamictargetattainmentofmeropeneminpediatricpatients |