Evidence map›Paper›PMID 36422708›Full record

Observational studyEuropean journal of pediatrics2023

Beta-lactam exposure and safety in intermittent or continuous infusion in critically ill children: an observational monocenter study.

Agathe Debray, Delphine Callot, Déborah Hirt, Emmanuelle Bille, Sylvain Renolleau, Laurent Chouchana, Jean-Marc Tréluyer, Mehdi Oualha, Agathe Béranger

Erratum issuedAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Agathe DebrayPédiatrie Générale Et Maladies Infectieuses, Hôpital Necker-Enfants Malades, AP-HP, Université de Paris, Paris, France.
Delphine CallotHôpital Necker-Enfants Malades, AP-HP, Université de Paris, Pharmacovigilance, Paris, France.
Déborah HirtPharmacologie Et Évaluations Thérapeutiques Chez L'enfant Et La Femme Enceinte, EA7323, Paris, France.ORCID http://orcid.org/0000-0002-9898-2609
Emmanuelle BilleLaboratoire de Microbiologie, Hôpital Necker-Enfants Malades, AP-HP, Université de Paris, Paris, France.
Sylvain RenolleauRéanimation Et Surveillance Continue Médico-Chirurgicales Pédiatriques, Hôpital Necker-Enfants Malades, AP-HP, Université de Paris, 149 Rue de Sèvres, 75015, Paris, France.ORCID http://orcid.org/0000-0002-0638-5613
Laurent ChouchanaHôpital Necker-Enfants Malades, AP-HP, Université de Paris, Pharmacovigilance, Paris, France.ORCID http://orcid.org/0000-0002-9626-3571
Jean-Marc TréluyerPharmacologie Et Évaluations Thérapeutiques Chez L'enfant Et La Femme Enceinte, EA7323, Paris, France.
Mehdi OualhaPharmacologie Et Évaluations Thérapeutiques Chez L'enfant Et La Femme Enceinte, EA7323, Paris, France.ORCID http://orcid.org/0000-0002-0488-5948
Agathe BérangerPharmacologie Et Évaluations Thérapeutiques Chez L'enfant Et La Femme Enceinte, EA7323, Paris, France. agathe.beranger@gmail.com.ORCID http://orcid.org/0000-0002-9751-8249
Hôpital Necker-Enfants Malades · FRHôpital Femme Mère Enfant · FRInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of this study was to assess the pharmacokinetic (PK) exposure and clinical toxicity for three beta-lactams: cefotaxime, piperacillin/tazobactam, and meropenem, depending on two lengths of infusion: continuous and intermittent, in critically ill children. This single center observational prospective study was conducted in a pediatric intensive care unit. All hospitalized children who had one measured plasma concentration of the investigated antibiotics were included. Plasma antibiotic concentrations were interpreted by a pharmacologist, using a Bayesian approach based on previously published population pharmacokinetic models in critically ill children. Exposure was considered optimal, low, or high according to the PK target 100% fT

conclusionCI provided a higher probability to attain an optimal PK target compared to II, but also a higher risk for overexposure. Regular therapeutic drug monitoring is recommended in critically ill children receiving beta-lactams, regardless of the length of infusion. WHAT IS KNOWN: • Since beta-lactams are time-dependent antibiotics, the probability to attain the pharmacokinetic target is higher with continuous infusion compared to that with intermittent infusion. • In daily practice, continuous or extended infusions are rarely used despite recent guidelines, and toxicity is hardly reported. WHAT IS NEW: • Continuous infusion provided a higher probability to attain an optimal pharmacokinetic target compared to intermittent infusion, but also a higher risk of overexposure. • Regular therapeutic drug monitoring is recommended in critically ill children receiving beta-lactams, regardless of the length of infusion.

Indexed as

beta-LactamsCritical IllnessAnti-Bacterial AgentsBayes TheoremCefotaximeChildHumansInfusions, IntravenousMeropenemPiperacillinProspective StudiesAnti-Bacterial Agentsbeta-LactamsCefotaximeMeropenemPiperacillinAdverse effectsCefotaximeMeropenemPediatric intensive care unitPharmacokineticsPiperacillin

Identifiers

PMID36422708
OpenAlexW4309886650

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.