Observational studyThe Pediatric infectious disease journal2025
Urinary Biomarkers and Attainment of Cefepime Therapeutic Targets in Critically Ill Children.
Observational study in The Pediatric infectious disease journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Ceftaroline pharmacokinetics on ECMO, a pediatric case report.International journal of antimicrobial agents · 2026Article
- Urine NGAL adds to serum creatinine in predicting cefepime clearance in critically ill children at high risk of acute kidney injury.International journal of antimicrobial agents · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundCritically ill children are at risk for subtherapeutic antibiotic concentrations. The frequency of target attainment and risk factors for subtherapeutic concentrations of cefepime in children have not been extensively studied.
methodsWe performed an observational study in critically ill children receiving a new prescription of standard dosing of cefepime for suspected sepsis (≥2 systemic inflammatory response syndrome criteria within 48 hours of cefepime start). Three plasma cefepime concentrations were measured at steady state and, a urine sample was collected prior to pharmacokinetics (PK) sampling for measurement of urinary biomarkers. Bayesian analysis determined cefepime PK for each individual, and simulations were used to estimate time above minimum inhibitory concentration ( f T > MIC) for 8 µg/mL (breakpoint for Pseudomonas ). Clinical factors and urinary biomarkers were compared between patients who did and did not achieve 100% f T > MIC. Correlations between covariates and cefepime PK parameters, as well as optimal cut points to identify <100% f T > MIC, were evaluated.
resultsTwenty-one subjects were enrolled and PK sampling occurred after a median of 5 doses (range, 3-9); 43% of children achieved 100% f T > MIC for an MIC of 8 µg/mL. Younger age and lower urinary biomarkers (neutrophil gelatinase-associated lipocalin and kidney injury molecule-1) were significantly associated with failure to attain 100% f T > 8 µg/mL. Urinary neutrophil gelatinase-associated lipocalin (<122.1-ng/mg creatinine) best identified individuals who failed to attain this putative target (positive predictive value, 91.7%).
conclusionsA large proportion of critically ill children failed to attain target concentrations for empiric treatment of Pseudomonas aeruginosa with cefepime. Urinary biomarkers may be a noninvasive means to identify those at higher risk for increased cefepime clearance and subtherapeutic concentrations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.