Evidence map›Paper›PMID 41664494›Full record

ArticleBritish journal of clinical pharmacology2026

High-dose ceftriaxone: Pharmacokinetic and pharmacodynamic insights in hospitalized patients with suspected sepsis in Thailand.

Nattapat Sangkakul, Apinya Boonpeng, Pisud Siripaitoon, Narongdet Kositpantawong, Siripen Kanchanasuwan, Sorawit Chittrakarn, Monchana Jullangkoon, Boonsri Charoenmak, Sarunyou Chusri

Abstract read
In one paragraph

Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Nattapat SangkakulDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0009-0001-4250-9484
Apinya BoonpengDivision of Clinical Pharmacy, Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences, University of Phayao, Muang District, Phayao, Thailand.ORCID https://orcid.org/0000-0002-6169-0039
Pisud SiripaitoonDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0000-0002-6244-3566
Narongdet KositpantawongDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0000-0001-6929-2089
Siripen KanchanasuwanDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0000-0002-6311-7463
Sorawit ChittrakarnDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0009-0007-8115-3955
Monchana JullangkoonDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0009-0000-9938-9199
Boonsri CharoenmakDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Sarunyou ChusriDivision of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.ORCID https://orcid.org/0000-0002-3116-2518

Funding

Faculty of Medicine, Prince of Songkla UniversityUniversity of Phayao and Thailand Science Research and Innovation Fund (Fundamental Fund 2025) 2293/2568
6 · The paper itself

Abstract

aimAppropriate drug exposure is as crucial as proper selection and timely antibiotic administration in sepsis treatment. However, evidence is lacking regarding the current dosing regimen to achieve pharmacodynamic targets. This study aimed to describe ceftriaxone pharmacokinetic (PK) parameters and establish optimal dosing regimens for sepsis patients.

methodsThis study investigated the pharmacokinetics of ceftriaxone in sepsis patients receiving ceftriaxone 2 g every 12 or 24 h. Blood samples (11-14 samples per patient) were collected within the first 24 h post-administration. PK parameters were estimated from unbound plasma concentrations using a nonlinear mixed-effects modelling approach (NONMEM® software). Monte Carlo simulations were conducted to evaluate the probability of target attainment of standard and high-dose ceftriaxone at various minimum inhibitory concentrations (MICs).

resultsPopulation PK analysis of 238 concentration-time data points from 20 patients revealed that a two-compartment model best described ceftriaxone PK. Glomerular filtration rate (GFR), serum albumin, and body weight significantly affected clearance, volume of distribution, and intercompartmental clearance, respectively. Simulation demonstrated that standard dose of 2 g every 24 h was adequate for pathogens with MIC ≤1 mg L

conclusionStandard ceftriaxone (2 g intravenous q 24 h, 30-min infusion) provided adequate target attainment at low MICs in this exploratory study of suspected sepsis. PTA decreased with higher MICs and higher renal function, with higher dose regimens showing numerically greater exposures. These findings may help guide future studies on dosing optimization.

Indexed as

Anti-Bacterial AgentsCeftriaxoneModels, BiologicalSepsisAdultAgedAged, 80 and overDose-Response Relationship, DrugDrug Administration ScheduleFemaleGlomerular Filtration RateHumansMaleMicrobial Sensitivity TestsMiddle AgedMonte Carlo MethodAnti-Bacterial AgentsCeftriaxoneSecond Generation CephalosporinsThird Generation Cephalosporinsantibiotic dosingceftriaxonepharmacodynamicspharmacokineticssepsis

Identifiers

PMID41664494
PMCPMC13370036

What OpenQuestion holds

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Registered trials

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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.