ArticleClinical pharmacokinetics2023
Optimization of β-Lactam Dosing Regimens in Neonatal Infections: Continuous and Extended Administration versus Intermittent Administration.
Article in Clinical pharmacokinetics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- Population pharmacokinetics and safety of continuous oxacillin in preterm and term neonates and infants.Antimicrobial agents and chemotherapy · 2026Article
- Population pharmacokinetic modeling and simulation-informed ceftazidime dosing in Chinese neonates using quantitative dried blood spot micro-sampling.Antimicrobial agents and chemotherapy · 2026Article
- Penicillin Concentrations in Oropharyngeal and Frontal Sinus Tissue Following Intravenous Bolus and Continuous Infusion - An Experimental Porcine Study.Pharmaceutical research · 2026Article
- 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
- Population pharmacokinetics and dose optimization of piperacillin-tazobactam in premature and term neonates with severe infections.Antimicrobial agents and 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
- Effect of β-lactam antibiotics on the gut microbiota of term neonates.Annals of clinical microbiology and antimicrobials · 2024Article
- Review
- [Clinical practice guidelines for meropenem therapy in neonatal sepsis (2024)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- Population pharmacokinetics and dose optimization of ceftazidime in critically ill children.Frontiers in pharmacology · 2024Article
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Authors and funding
6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveIn neonates, β-Lactam antibiotics are almost exclusively administered by intermittent infusion. However, continuous or prolonged infusion may be more beneficial because of the time-dependent antibacterial activity. In this pharmacokinetic/pharmacodynamic simulation study, we aimed to compare treatment with continuous, extended and intermittent infusion of β-lactam antibiotics for neonates with infectious diseases.
methodsWe selected population pharmacokinetic models of penicillin G, amoxicillin, flucloxacillin, cefotaxime, ceftazidime and meropenem, and performed a Monte Carlo simulation with 30,000 neonates. Four different dosing regimens were simulated: intermittent infusion in 30 min, prolonged infusion in 4 h, continuous infusion, and continuous infusion with a loading dose. The primary endpoint was 90% probability of target attainment (PTA) for 100% ƒT>MIC during the first 48 h of treatment.
resultsFor all antibiotics except cefotaxime, continuous infusion with a loading dose resulted in a higher PTA compared with other dosing regimens. Sufficient exposure (PTA >90%) using continuous infusion with a loading dose was reached for amoxicillin (90.3%), penicillin G (PTA 98.4%), flucloxacillin (PTA 94.3%), cefotaxime (PTA 100%), and ceftazidime (PTA 100%). Independent of dosing regimen, higher meropenem (PTA for continuous infusion with a loading dose of 85.5%) doses might be needed to treat severe infections in neonates. Ceftazidime and cefotaxime dose might be unnecessarily high, as even with dose reductions, a PTA > 90% was retained.
conclusionsContinuous infusion after a loading dose leads to a higher PTA compared with continuous, intermittent or prolonged infusion, and therefore has the potential to improve treatment with β-lactam antibiotics in neonates.
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