Cargando…

Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants

Neonatal Infections are among the most common reasons for admission to the intensive care unit. Neonatal sepsis (NS) significantly contributes to mortality rates. Empiric antibiotic therapy of NS recommended by current international guidelines includes benzylpenicillin, ampicillin/amoxicillin, and a...

Descripción completa

Detalles Bibliográficos
Autores principales: Butranova, Olga I., Ushkalova, Elena A., Zyryanov, Sergey K., Chenkurov, Mikhail S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046592/
https://www.ncbi.nlm.nih.gov/pubmed/36979919
http://dx.doi.org/10.3390/biomedicines11030940
_version_ 1785013711981772800
author Butranova, Olga I.
Ushkalova, Elena A.
Zyryanov, Sergey K.
Chenkurov, Mikhail S.
author_facet Butranova, Olga I.
Ushkalova, Elena A.
Zyryanov, Sergey K.
Chenkurov, Mikhail S.
author_sort Butranova, Olga I.
collection PubMed
description Neonatal Infections are among the most common reasons for admission to the intensive care unit. Neonatal sepsis (NS) significantly contributes to mortality rates. Empiric antibiotic therapy of NS recommended by current international guidelines includes benzylpenicillin, ampicillin/amoxicillin, and aminoglycosides (gentamicin). The rise of antibacterial resistance precipitates the growth of the use of antibiotics of the Watch (second, third, and fourth generations of cephalosporines, carbapenems, macrolides, glycopeptides, rifamycins, fluoroquinolones) and Reserve groups (fifth generation of cephalosporines, oxazolidinones, lipoglycopeptides, fosfomycin), which are associated with a less clinical experience and higher risks of toxic reactions. A proper dosing regimen is essential for effective and safe antibiotic therapy, but its choice in neonates is complicated with high variability in the maturation of organ systems affecting drug absorption, distribution, metabolism, and excretion. Changes in antibiotic pharmacokinetic parameters result in altered efficacy and safety. Population pharmacokinetics can help to prognosis outcomes of antibiotic therapy, but it should be considered that the neonatal population is heterogeneous, and this heterogeneity is mainly determined by gestational and postnatal age. Preterm neonates are common in clinical practice, and due to the different physiology compared to the full terms, constitute a specific neonatal subpopulation. The objective of this review is to summarize the evidence about the developmental changes (specific for preterm and full-term infants, separately) of pharmacokinetic parameters of antibiotics used in neonatal intensive care units.
format Online
Article
Text
id pubmed-10046592
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100465922023-03-29 Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants Butranova, Olga I. Ushkalova, Elena A. Zyryanov, Sergey K. Chenkurov, Mikhail S. Biomedicines Review Neonatal Infections are among the most common reasons for admission to the intensive care unit. Neonatal sepsis (NS) significantly contributes to mortality rates. Empiric antibiotic therapy of NS recommended by current international guidelines includes benzylpenicillin, ampicillin/amoxicillin, and aminoglycosides (gentamicin). The rise of antibacterial resistance precipitates the growth of the use of antibiotics of the Watch (second, third, and fourth generations of cephalosporines, carbapenems, macrolides, glycopeptides, rifamycins, fluoroquinolones) and Reserve groups (fifth generation of cephalosporines, oxazolidinones, lipoglycopeptides, fosfomycin), which are associated with a less clinical experience and higher risks of toxic reactions. A proper dosing regimen is essential for effective and safe antibiotic therapy, but its choice in neonates is complicated with high variability in the maturation of organ systems affecting drug absorption, distribution, metabolism, and excretion. Changes in antibiotic pharmacokinetic parameters result in altered efficacy and safety. Population pharmacokinetics can help to prognosis outcomes of antibiotic therapy, but it should be considered that the neonatal population is heterogeneous, and this heterogeneity is mainly determined by gestational and postnatal age. Preterm neonates are common in clinical practice, and due to the different physiology compared to the full terms, constitute a specific neonatal subpopulation. The objective of this review is to summarize the evidence about the developmental changes (specific for preterm and full-term infants, separately) of pharmacokinetic parameters of antibiotics used in neonatal intensive care units. MDPI 2023-03-17 /pmc/articles/PMC10046592/ /pubmed/36979919 http://dx.doi.org/10.3390/biomedicines11030940 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Butranova, Olga I.
Ushkalova, Elena A.
Zyryanov, Sergey K.
Chenkurov, Mikhail S.
Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title_full Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title_fullStr Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title_full_unstemmed Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title_short Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants
title_sort developmental pharmacokinetics of antibiotics used in neonatal icu: focus on preterm infants
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046592/
https://www.ncbi.nlm.nih.gov/pubmed/36979919
http://dx.doi.org/10.3390/biomedicines11030940
work_keys_str_mv AT butranovaolgai developmentalpharmacokineticsofantibioticsusedinneonatalicufocusonpreterminfants
AT ushkalovaelenaa developmentalpharmacokineticsofantibioticsusedinneonatalicufocusonpreterminfants
AT zyryanovsergeyk developmentalpharmacokineticsofantibioticsusedinneonatalicufocusonpreterminfants
AT chenkurovmikhails developmentalpharmacokineticsofantibioticsusedinneonatalicufocusonpreterminfants