Uncertainty in Antibiotic Dosing in Critically Ill Neonate and Pediatric Patients: Can Microsampling Provide the Answers?

Dorofaeff, Tavey; Bandini, Rossella M.; Lipman, Jeffrey; Ballot, Daynia; Roberts, Jason A.; Parker, Suzanne L.

doi:10.1016/j.clinthera.2016.07.093

Cited by 30 publications

(21 citation statements)

References 120 publications

(114 reference statements)

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“…Many frequently used agents (e.g., ceftriaxone, ceftazidime, penicillin, flucloxacillin, metronidazole) even completely lack PK data in critically ill children. The PK studies that have been published report that conventional dosing strategies consistently fail to achieve the proper PK/ PD targets [95,96]. Specifically for β-lactam antibiotics, 95% of a PICU study population had sub-therapeutic concentrations [97].…”

Section: Right Dosagementioning

confidence: 99%

Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review

et al. 2020

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Section: Right Dosagementioning

confidence: 99%

Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review

et al. 2020

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“…Similar to sparse sampling, microsampling reduces the overall blood volume needed: whereas sparse sampling reduces the frequency, microsampling reduces the actual volume drawn during sampling. In fact, microsampling requires a volume <50 μL, which can be collected by skin prick …”

Section: Current Challenges With Potential Solutionsmentioning

confidence: 99%

“…In fact, microsampling requires a volume <50 μL, which can be collected by skin prick. 97 Dried blood spot is a sampling technique that utilizes an ultra-low volume (ie, 30 μL of whole blood, which is 20 times lower than traditional venous or arterial samples) to evaluate the PK of drugs. It is stable and reproducible on paper filters.…”

Section: Current Challenges With Potential Solutionsmentioning

confidence: 99%

Optimizing Antibiotic Drug Therapy in Pediatrics: Current State and Future Needs

Lê

Bradley

2018

The Journal of Clinical Pharma

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The selection of the right antibiotic and right dose necessitates clinicians understand the contribution of pharmacokinetic variability stemming from age‐related physiologic maturation and the pharmacodynamics to optimize drug exposure for clinical response. The complexity of selecting the right dose arises from the multiplicity of pediatric age groups, from premature neonates to adolescents. Body size and age (which relate to organ function) must be incorporated to optimize antibiotic dosing in this vulnerable population. In the effort to optimize and individualize drug dosing regimens, clinical pharmacometrics that incorporate population‐based pharmacokinetic modeling, Bayesian estimation, and Monte Carlo simulations are utilized as a quantitative approach to understanding and predicting the pharmacology and clinical and microbiologic efficacy of antibiotics. In addition, opportunistic study designs and alternative blood sampling strategies can serve as practical approaches to ensure successful conduct of pediatric studies. This review article examines relevant literature on optimization of antibiotic pharmacotherapy in pediatric populations published within the last decade. Specific pediatric antibiotic data, including beta‐lactam antibiotics, aminoglycosides, and vancomycin, are critically evaluated.

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“…However, the acquisition of useful pharmacological information requires multiple plasma measurements, which are difficult to collect in very-low-weight infants due to difficulties in finding accessible vessels and the limited volume of blood that can be collected (2). Several microsampling techniques have been developed, such as dried blood spot, capillary tube, and volumetric absorptive microsampling; however, validation of these methods is critical to ensure that the results are true (3). We compared four serial plasma levels of micafungin measured in blood samples collected simultaneously via central venous catheter and heel stick in eight at-term and preterm infants.…”

mentioning

confidence: 99%

Validation of Heel Stick Microsampling To Optimize Micafungin Doses in Neonates and Young Infants

Auriti

Goffredo

Ronchetti

et al. 2018

Antimicrob Agents Chemother

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Major gaps exist in our knowledge of antimicrobial pharmacokinetics in critically ill neonates and infants that require validated microsampling and bioanalysis methods to support therapeutic drug monitoring. We compared serially collected intravenous (i.v.) and heel stick capillary (HSC)-sampled plasma concentrations of micafungin (8 mg/kg) in eight infants born preterm with systemic candidiasis. The mean (standard deviation) micafungin area under the plasma concentration-time curve to infinity (AUC) was 316 (65.0) h · mg/liter based on HSC concentrations that strongly correlated ( = 0.92) with i.v. values to support dose adjustment.

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Uncertainty in Antibiotic Dosing in Critically Ill Neonate and Pediatric Patients: Can Microsampling Provide the Answers?

Cited by 30 publications

References 120 publications

Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review

Optimizing the Use of Antibiotic Agents in the Pediatric Intensive Care Unit: A Narrative Review

Optimizing Antibiotic Drug Therapy in Pediatrics: Current State and Future Needs

Validation of Heel Stick Microsampling To Optimize Micafungin Doses in Neonates and Young Infants

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