Cargando…

Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review

The antimicrobial therapy of sepsis and septic shock should be individualized based on pharmacokinetic/pharmacodynamic (PK/PD) parameters to deliver effective and timely treatment of life-threatening infections. We conducted a literature scoping review to identify therapeutic targets of beta-lactam...

Descripción completa

Detalles Bibliográficos
Autores principales: Morales Junior, Ronaldo, Pereira, Gabriela Otofuji, Tiguman, Gustavo Magno Baldin, Juodinis, Vanessa D'Amaro, Telles, João Paulo, de Souza, Daniela Carla, Santos, Silvia Regina Cavani Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960241/
https://www.ncbi.nlm.nih.gov/pubmed/35359889
http://dx.doi.org/10.3389/fped.2022.777854
_version_ 1784677347633397760
author Morales Junior, Ronaldo
Pereira, Gabriela Otofuji
Tiguman, Gustavo Magno Baldin
Juodinis, Vanessa D'Amaro
Telles, João Paulo
de Souza, Daniela Carla
Santos, Silvia Regina Cavani Jorge
author_facet Morales Junior, Ronaldo
Pereira, Gabriela Otofuji
Tiguman, Gustavo Magno Baldin
Juodinis, Vanessa D'Amaro
Telles, João Paulo
de Souza, Daniela Carla
Santos, Silvia Regina Cavani Jorge
author_sort Morales Junior, Ronaldo
collection PubMed
description The antimicrobial therapy of sepsis and septic shock should be individualized based on pharmacokinetic/pharmacodynamic (PK/PD) parameters to deliver effective and timely treatment of life-threatening infections. We conducted a literature scoping review to identify therapeutic targets of beta-lactam antibiotics in septic pediatric patients and the strategies that have been applied to overcome sepsis-related altered pharmacokinetics and increase target attainment against susceptible pathogens. A systematic search was conducted in the MEDLINE, EMBASE and Web of Science databases to select studies conducted since 2010 with therapeutic monitoring data of beta-lactams in septic children. Last searches were performed on 02 September 2021. Two independent authors selected the studies and extracted the data. A narrative and qualitative approach was used to summarize the findings. Out of the 118 identified articles, 21 met the eligibility criteria. Population pharmacokinetic modeling was performed in 12 studies, while nine studies reported data from bedside monitoring of beta-lactams. Most studies were conducted in the United States of America (n = 9) and France (n = 5) and reported PK/PD data of amoxicillin, ampicillin, azlocillin, aztreonam, cefazolin, cefepime, cefotaxime, ceftaroline, ceftazidime, doripenem, meropenem and piperacillin/tazobactam. Therapeutic targets ranged from to 40% fT> MIC to 100% fT> 6 × MIC. Prolonging the infusion time and frequency were most described strategies to increase target attainment. Monitoring beta-lactam serum concentrations in clinical practice may potentially maximize therapeutic target attainment. Further studies are required to define the therapeutic target associated with the best clinical outcomes.
format Online
Article
Text
id pubmed-8960241
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-89602412022-03-30 Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review Morales Junior, Ronaldo Pereira, Gabriela Otofuji Tiguman, Gustavo Magno Baldin Juodinis, Vanessa D'Amaro Telles, João Paulo de Souza, Daniela Carla Santos, Silvia Regina Cavani Jorge Front Pediatr Pediatrics The antimicrobial therapy of sepsis and septic shock should be individualized based on pharmacokinetic/pharmacodynamic (PK/PD) parameters to deliver effective and timely treatment of life-threatening infections. We conducted a literature scoping review to identify therapeutic targets of beta-lactam antibiotics in septic pediatric patients and the strategies that have been applied to overcome sepsis-related altered pharmacokinetics and increase target attainment against susceptible pathogens. A systematic search was conducted in the MEDLINE, EMBASE and Web of Science databases to select studies conducted since 2010 with therapeutic monitoring data of beta-lactams in septic children. Last searches were performed on 02 September 2021. Two independent authors selected the studies and extracted the data. A narrative and qualitative approach was used to summarize the findings. Out of the 118 identified articles, 21 met the eligibility criteria. Population pharmacokinetic modeling was performed in 12 studies, while nine studies reported data from bedside monitoring of beta-lactams. Most studies were conducted in the United States of America (n = 9) and France (n = 5) and reported PK/PD data of amoxicillin, ampicillin, azlocillin, aztreonam, cefazolin, cefepime, cefotaxime, ceftaroline, ceftazidime, doripenem, meropenem and piperacillin/tazobactam. Therapeutic targets ranged from to 40% fT> MIC to 100% fT> 6 × MIC. Prolonging the infusion time and frequency were most described strategies to increase target attainment. Monitoring beta-lactam serum concentrations in clinical practice may potentially maximize therapeutic target attainment. Further studies are required to define the therapeutic target associated with the best clinical outcomes. Frontiers Media S.A. 2022-03-10 /pmc/articles/PMC8960241/ /pubmed/35359889 http://dx.doi.org/10.3389/fped.2022.777854 Text en Copyright © 2022 Morales Junior, Pereira, Tiguman, Juodinis, Telles, de Souza and Santos. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Morales Junior, Ronaldo
Pereira, Gabriela Otofuji
Tiguman, Gustavo Magno Baldin
Juodinis, Vanessa D'Amaro
Telles, João Paulo
de Souza, Daniela Carla
Santos, Silvia Regina Cavani Jorge
Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title_full Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title_fullStr Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title_full_unstemmed Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title_short Beta-Lactams Therapeutic Monitoring in Septic Children–What Target Are We Aiming for? A Scoping Review
title_sort beta-lactams therapeutic monitoring in septic children–what target are we aiming for? a scoping review
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960241/
https://www.ncbi.nlm.nih.gov/pubmed/35359889
http://dx.doi.org/10.3389/fped.2022.777854
work_keys_str_mv AT moralesjuniorronaldo betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT pereiragabrielaotofuji betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT tigumangustavomagnobaldin betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT juodinisvanessadamaro betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT tellesjoaopaulo betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT desouzadanielacarla betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview
AT santossilviareginacavanijorge betalactamstherapeuticmonitoringinsepticchildrenwhattargetareweaimingforascopingreview