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Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies
As antimicrobial susceptibility of common bacterial pathogens decreases, ensuring optimal dosing may preserve the use of older antibiotics in order to limit the spread of resistance to newer agents. Beta‐lactams represent the most widely prescribed antibiotic class, yet most were licensed prior to l...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358626/ https://www.ncbi.nlm.nih.gov/pubmed/33521971 http://dx.doi.org/10.1002/cpt.2180 |
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author | Gastine, Silke Hsia, Yingfen Clements, Michelle Barker, Charlotte I.S. Bielicki, Julia Hartmann, Christine Sharland, Mike Standing, Joseph F. |
author_facet | Gastine, Silke Hsia, Yingfen Clements, Michelle Barker, Charlotte I.S. Bielicki, Julia Hartmann, Christine Sharland, Mike Standing, Joseph F. |
author_sort | Gastine, Silke |
collection | PubMed |
description | As antimicrobial susceptibility of common bacterial pathogens decreases, ensuring optimal dosing may preserve the use of older antibiotics in order to limit the spread of resistance to newer agents. Beta‐lactams represent the most widely prescribed antibiotic class, yet most were licensed prior to legislation changes mandating their study in children. As a result, significant heterogeneity persists in the pediatric doses used globally, along with quality of evidence used to inform dosing. This review summarizes dosing recommendations from the major pediatric reference sources and tries to answer the questions: Does beta‐lactam dose heterogeneity matter? Does it impact pharmacodynamic target attainment? For three important severe clinical infections—pneumonia, sepsis, and meningitis—pharmacokinetic models were identified for common for beta‐lactam antibiotics. Real‐world demographics were derived from three multicenter point prevalence surveys. Simulation results were compared with minimum inhibitory concentration distributions to inform appropriateness of recommended doses in targeted and empiric treatment. While cephalosporin dosing regimens are largely adequate for target attainment, they also pose the most risk of neurotoxicity. Our review highlights aminopenicillin, piperacillin, and meropenem doses as potentially requiring review/optimization in order to preserve the use of these agents in future. |
format | Online Article Text |
id | pubmed-8358626 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83586262021-08-15 Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies Gastine, Silke Hsia, Yingfen Clements, Michelle Barker, Charlotte I.S. Bielicki, Julia Hartmann, Christine Sharland, Mike Standing, Joseph F. Clin Pharmacol Ther Reviews As antimicrobial susceptibility of common bacterial pathogens decreases, ensuring optimal dosing may preserve the use of older antibiotics in order to limit the spread of resistance to newer agents. Beta‐lactams represent the most widely prescribed antibiotic class, yet most were licensed prior to legislation changes mandating their study in children. As a result, significant heterogeneity persists in the pediatric doses used globally, along with quality of evidence used to inform dosing. This review summarizes dosing recommendations from the major pediatric reference sources and tries to answer the questions: Does beta‐lactam dose heterogeneity matter? Does it impact pharmacodynamic target attainment? For three important severe clinical infections—pneumonia, sepsis, and meningitis—pharmacokinetic models were identified for common for beta‐lactam antibiotics. Real‐world demographics were derived from three multicenter point prevalence surveys. Simulation results were compared with minimum inhibitory concentration distributions to inform appropriateness of recommended doses in targeted and empiric treatment. While cephalosporin dosing regimens are largely adequate for target attainment, they also pose the most risk of neurotoxicity. Our review highlights aminopenicillin, piperacillin, and meropenem doses as potentially requiring review/optimization in order to preserve the use of these agents in future. John Wiley and Sons Inc. 2021-02-28 2021-04 /pmc/articles/PMC8358626/ /pubmed/33521971 http://dx.doi.org/10.1002/cpt.2180 Text en © 2021 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Reviews Gastine, Silke Hsia, Yingfen Clements, Michelle Barker, Charlotte I.S. Bielicki, Julia Hartmann, Christine Sharland, Mike Standing, Joseph F. Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title | Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title_full | Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title_fullStr | Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title_full_unstemmed | Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title_short | Variation in Target Attainment of Beta‐Lactam Antibiotic Dosing Between International Pediatric Formularies |
title_sort | variation in target attainment of beta‐lactam antibiotic dosing between international pediatric formularies |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358626/ https://www.ncbi.nlm.nih.gov/pubmed/33521971 http://dx.doi.org/10.1002/cpt.2180 |
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