ArticleTherapeutic advances in drug safety2025
Navigating pharmacokinetic and pharmacodynamics challenges of β-lactam antibiotics in patients with low body weight: efficacy, toxicity, and dosage optimization.
Article in Therapeutic advances in drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis to identify meropenem exposures and pharmacological targets predictive of clinical outcomes.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Pyridoxic Acid as a Novel Endogenous Biomarker for OAT-Mediated Clearance of Meropenem: A Population Pharmacokinetic Modeling and PK/PD-Response Analysis in Patients with Sepsis.Pharmaceutics · 2026Article
- Optimal Piperacillin/Tazobactam Dosing in Adults with Low Body Weight: A Population Pharmacokinetic and Simulation-Based Study.Drug design, development and therapy · 2026Observational
- Real-world efficacy and safety of cefepime for pediatric community-acquired pneumonia: a propensity score-matched study.Frontiers in cellular and infection microbiology · 2025Article
- Prevalence of on time administration of carbapenem and its impact on PK/PD target attainment in hospitalized patients: a multicenter retrospective study.Frontiers in cellular and infection microbiology · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Patients with low body weight (LBW) often exhibit altered pharmacokinetics (PK) in renal clearance and total body water. These changes complicate β-lactam antibiotic dosing, potentially resulting in suboptimal efficacy or increased toxicity. Objectives: To evaluate the attainment of PK/pharmacodynamic (PD) targets, the prevalence of subtherapeutic and supratherapeutic concentrations, and the incidence of neurotoxicity among LBW patients treated with piperacillin/tazobactam (TZP), cefepime (FEP), and meropenem (MEM). Design: A prospective observational study conducted at a tertiary hospital from January 2020 to December 2022. Methods: Adult patients with a body mass index ⩽18.5 kg/m Results: Seventy-two patients were included: 29 received TZP, 23 FEP, and 20 MEM. Achievement of the 100% fT > MIC target was comparable across all antibiotics (~70%), but 100% fT > 4 MIC attainment was significantly higher for FEP (47.8%) than for TZP (10.3%) and MEM (30%) ( Conclusion: PK changes complicate β-lactam antibiotic dosing, resulting in frequent failure to achieve PK/PD targets. FEP demonstrated a particularly high risk of supratherapeutic concentrations and neurotoxicity. Therapeutic drug monitoring is crucial to optimize dosing and improve safety in this population.
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