ArticleAntimicrobial agents and chemotherapy2010
Pharmacokinetics of cefotaxime and desacetylcefotaxime in infants during extracorporeal membrane oxygenation.
Article in Antimicrobial agents and chemotherapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmacokinetics of Commonly Used Antimicrobials in Critically Ill Pediatric Patients During Extracorporeal Membrane Oxygenation: A Systematic Review.Paediatric drugs · 2023Pooled it
- Pharmacokinetics Alterations in Critically Ill Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review.Frontiers in pediatrics · 2020Pooled it
- Population Pharmacokinetic Model to Optimize Cefotaxime Dosing Regimen in Critically Ill Children.Clinical pharmacokinetics · 2018Trial
- Micellar Encapsulation of Propofol Reduces its Adsorption on Extracorporeal Membrane Oxygenator (ECMO) Circuit.The AAPS journal · 2023Article
- Population pharmacokinetics in critically ill neonates and infants undergoing extracorporeal membrane oxygenation: a literature review.BMJ paediatrics open · 2022Review
- Cefepime Extraction by Extracorporeal Life Support Circuits.The journal of extra-corporeal technology · 2022Article
- Population pharmacokinetics of cefotaxime in intensive care patients.European journal of clinical pharmacology · 2022Article
- Pharmacokinetics of Antibiotics in Pediatric Intensive Care: Fostering Variability to Attain Precision Medicine.Antibiotics (Basel, Switzerland) · 2021Review
- Amiodarone Extraction by the Extracorporeal Membrane Oxygenation Circuit.The journal of extra-corporeal technology · 2021Article
- Drug Disposition and Pharmacotherapy in Neonatal ECMO: From Fragmented Data to Integrated Knowledge.Frontiers in pediatrics · 2019Review
- Optimising drug dosing in patients receiving extracorporeal membrane oxygenation.Journal of thoracic disease · 2018Review
- Drugs pharmacokinetics during veno-venous extracorporeal membrane oxygenation in pediatrics.Journal of thoracic disease · 2018Review
- Dosing antibiotics in neonates: review of the pharmacokinetic data.Future microbiology · 2017Article
- Population Pharmacokinetics and Dose Optimization of Teicoplanin during Venoarterial Extracorporeal Membrane Oxygenation.Antimicrobial agents and chemotherapy · 2017Article
- Antifungal Extraction by the Extracorporeal Membrane Oxygenation Circuit.The journal of extra-corporeal technology · 2017Article
- Clinical Pharmacology Studies in Critically Ill Children.Pharmaceutical research · 2017Review
- A Population and Developmental Pharmacokinetic Analysis To Evaluate and Optimize Cefotaxime Dosing Regimen in Neonates and Young Infants.Antimicrobial agents and chemotherapy · 2016Article
- Pharmacokinetics and Dosing of Anti-infective Drugs in Patients on Extracorporeal Membrane Oxygenation: A Review of the Current Literature.Clinical therapeutics · 2016Review
- Ethics of drug research in the pediatric intensive care unit.Paediatric drugs · 2015Review
- Ultrastructural Changes in Clinical and Microbiota Isolates of Klebsiella pneumoniae Carriers of Genes bla SHV, bla TEM, bla CTX-M, or bla KPC When Subject to β-Lactam Antibiotics.TheScientificWorldJournal · 2015Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Extracorporeal membrane oxygenation (ECMO) is used to temporarily sustain cardiac and respiratory function in critically ill infants but can cause pharmacokinetic changes necessitating dose modifications. Cefotaxime (CTX) is used to prevent and treat infections during ECMO, but the current dose regimen is based on pharmacokinetic data obtained for non-ECMO patients. The objective of this study was to validate the standard dose regimen of 50 mg/kg of body weight twice a day (postnatal age [PNA], <1 week), 50 mg/kg three times a day (PNA, 1 to 4 weeks), or 37.5 mg/kg four times a day (PNA, >4 weeks). We included 37 neonates on ECMO, with a median (range) PNA of 3.3 (0.67 to 199) days and a median (range) body weight of 3.5 (2.0 to 6.2) kg at the onset of ECMO. Median (range) ECMO duration was 108 (16 to 374) h. Plasma samples were taken during routine care, and pharmacokinetic analysis of CTX and its active metabolite, desacetylcefotaxime (DACT), was done using nonlinear mixed-effects modeling (NONMEM). A one-compartment pharmacokinetic model for CTX and DACT adequately described the data. During ECMO, CTX clearance (CL(CTX)) was 0.36 liter/h (range, 0.19 to 0.75 liter/h), the volume of distribution of CTX (V(CTX)) was 1.82 liters (0.73 to 3.02 liters), CL(DACT) was 1.46 liters/h (0.48 to 5.93 liters/h), and V(DACT) was 11.0 liters (2.32 to 28.0 liters). Elimination half-lives for CTX and DACT were 3.5 h (1.6 to 6.8 h) and 5.4 h (0.8 to 14 h). Peak CTX concentration was 98.0 mg/liter (33.2 to 286 mg/liter). DACT concentration varied between 0 and 38.2 mg/liter, with a median of 10 mg/liter in the first 12 h postdose. Overall, CTX concentrations were above the MIC of 8 mg/liter over the entire dose interval. Only 1 of the 37 patients had a sub-MIC concentration for over 50% of the dose interval. In conclusion, the standard cefotaxime dose regimen provides sufficiently long periods of supra-MIC concentrations to provide adequate treatment of infants on ECMO.
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