Evidence map›Paper›PMID 33030704›Full record

Observational studyClinical pharmacokinetics2021

Population Pharmacokinetics of Unbound and Total Teicoplanin in Critically Ill Pediatric Patients.

L B S Aulin, P De Paepe, E Dhont, A de Jaeger, J Vande Walle, W Vandenberghe, B C McWhinney, J P J Ungerer, J G C van Hasselt, P A J G De Cock

Open access · greenAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical pharmacokinetics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

L B S AulinSystems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.
P De PaepeHeymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
E DhontDepartment of Pediatric Intensive Care, Ghent University Hospital, Ghent, Belgium.
A de JaegerDepartment of Pediatric Intensive Care, Ghent University Hospital, Ghent, Belgium.
J Vande WalleDepartment of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.
W VandenbergheDepartment of Pediatric Intensive Care, Ghent University Hospital, Ghent, Belgium.
B C McWhinneyDepartment of Chemical Pathology, Pathology Queensland, Brisbane, QLD, Australia.
J P J UngererDepartment of Chemical Pathology, Pathology Queensland, Brisbane, QLD, Australia.
J G C van HasseltSystems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.
P A J G De CockHeymans Institute of Pharmacology, Ghent University, Ghent, Belgium. pieter.decock@uzgent.be.ORCID http://orcid.org/0000-0001-7634-7471
Ghent University Hospital · BELeiden University · NLQueensland Health · AUGhent University · BEUniversity College Ghent · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesTeicoplanin is a highly protein-bound antibiotic, increasingly used to treat serious Gram-positive infections in critically ill children. Maturational and pathophysiological intensive care unit-related changes often lead to altered pharmacokinetics. In this study, the objectives were to develop a pediatric population-pharmacokinetic model of unbound and total teicoplanin concentrations, to investigate the impact of plasma albumin levels and renal function on teicoplanin pharmacokinetics, and to evaluate the efficacy of the current weight-based dosing regimen.

methodsAn observational pharmacokinetic study was performed and blood samples were collected for quantification of unbound and total concentrations of teicoplanin after the first dose and in assumed steady-state conditions. A population-pharmacokinetic analysis was conducted using a standard sequential approach and Monte Carlo simulations were performed for a probability of target attainment analysis using previously published pharmacokinetic-pharmacodynamic targets.

resultsA two-compartment model with allometric scaling of pharmacokinetic parameters and non-linear plasma protein binding best described the data. Neither the inclusion of albumin nor the renal function significantly improved the model and no other covariates were supported for inclusion in the final model. The probability of target attainment analysis showed that the standard dosing regimen does not satisfactory attain the majority of the proposed targets.

conclusionsWe successfully characterized the pharmacokinetics of unbound and total teicoplanin in critically ill pediatric patients. The highly variable unbound fraction of teicoplanin could not be predicted using albumin levels, which may support the use of therapeutic drug monitoring of unbound concentrations. Poor target attainment was shown for the most commonly used dosing regimen, regardless of the pharmacokinetic-pharmacodynamic target evaluated.

Indexed as

Critical IllnessTeicoplaninAnti-Bacterial AgentsChildHumansMicrobial Sensitivity TestsMonte Carlo MethodAnti-Bacterial AgentsTeicoplanin

Identifiers

PMID33030704
OpenAlexW3092362987

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.