ArticleAntimicrobial agents and chemotherapy2019
Population Pharmacokinetics and Dosing Optimization of Amoxicillin in Neonates and Young Infants.
Article in Antimicrobial agents and chemotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review.Frontiers in pharmacology · 2022Pooled it
- Do the redefined EUCAST susceptibility categories warrant adjustment of paediatric antibiotic dosages? Pragmatic physiologically based pharmacokinetic modelling of four commonly used agents.The Journal of antimicrobial chemotherapy · 2026Article
- Evaluation of amoxicillin and benzylpenicillin therapy in early-onset neonatal sepsis: a pharmacometric external validation and simulation study.The Journal of antimicrobial chemotherapy · 2025Article
- A simplified amoxicillin regimen with dose frequency based on post-natal age in neonates with confirmed or suspected infection.Antimicrobial agents and chemotherapy · 2025Observational
- Optimal use of β-lactams in neonates: machine learning-based clinical decision support system.EBioMedicine · 2024Article
- Synergistic bactericidal activity of a novel dual β-lactam combination against methicillin-resistant Staphylococcus aureus.The Journal of antimicrobial chemotherapy · 2024Article
- CDC Guidelines for the Prevention and Treatment of Anthrax, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023Article
- Predicting Volume of Distribution in Neonates: Performance of Physiologically Based Pharmacokinetic Modelling.Pharmaceutics · 2023Article
- Appropriate Use of Antibiotic and Principles of Antimicrobial Stewardship in Children.Children (Basel, Switzerland) · 2023Article
- Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis.Children (Basel, Switzerland) · 2022Article
- Use of Antibiotics in Preterm Newborns.Antibiotics (Basel, Switzerland) · 2022Review
- Review of Scavenged Sampling for Sustainable Therapeutic Drug Monitoring: Do More With Less.Therapeutic drug monitoring · 2022Review
- Drug Clearance in Neonates: A Combination of Population Pharmacokinetic Modelling and Machine Learning Approaches to Improve Individual Prediction.Clinical pharmacokinetics · 2021Article
- The Pharmacokinetics of Beta-Lactam Antibiotics Using Scavenged Samples in Pediatric Intensive Care Patients: The EXPAT Kids Study Protocol.Frontiers in pharmacology · 2021Review
- Can Population Pharmacokinetics of Antibiotics be Extrapolated? Implications of External Evaluations.Clinical pharmacokinetics · 2021Review
- Initial Dosage Recommendation for Sirolimus in Children With Tuberous Sclerosis Complex.Frontiers in pharmacology · 2020Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Amoxicillin is widely used to treat bacterial infections in neonates. However, considerable intercenter variability in dosage regimens of antibiotics exists in clinical practice. The pharmacokinetics of amoxicillin has been described in only a few preterm neonates. Thus, we aimed to evaluate the population pharmacokinetics of amoxicillin through a large sample size covering the entire age range of neonates and young infants and to establish evidence-based dosage regimens based on developmental pharmacokinetics-pharmacodynamics. This is a prospective, multicenter, pharmacokinetic study using an opportunistic sampling design. Amoxicillin plasma concentrations were determined using high-performance liquid chromatography. Population pharmacokinetic analysis was performed using NONMEM. A total of 224 pharmacokinetic samples from 187 newborns (postmenstrual age range, 28.4 to 46.3 weeks) were available for analysis. A two-compartment model with first-order elimination was used to describe population pharmacokinetics. Covariate analysis showed that current weight, postnatal age, and gestational age were significant covariates. The final model was further validated for predictive performance in an independent cohort of patients. Monte Carlo simulation demonstrated that for early-onset sepsis, the currently used dosage regimen (25 mg/kg twice daily [BID]) resulted in 99.0% of premature neonates and 87.3% of term neonates achieving the pharmacodynamic target (percent time above MIC), using a MIC breakpoint of 1 mg/liter. For late-onset sepsis, 86.1% of premature neonates treated with 25 mg/kg three times a day (TID) and 79.0% of term neonates receiving 25 mg/kg four times a day (QID) reached the pharmacodynamic target, using a MIC breakpoint of 2 mg/liter. The population pharmacokinetics of amoxicillin was assessed in neonates and young infants. A dosage regimen was established based on developmental pharmacokinetics-pharmacodynamics.
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