Pharmacokinetic and Pharmacodynamic Considerations of Antibiotic Use in Neonates

The selection of an appropriate dose of a given antibiotic for a neonate not only requires knowledge of the drug's basic pharmacokinetic (PK) and pharmacodynamic (PD) properties but also the profound effects that organ development might have on the volume of distribution and clearance, both of...

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Bibliographic Details
Published in:Antibiotics (Basel) 2023-12, Vol.12 (12), p.1747
Main Authors: Regazzi, Mario, Berardi, Alberto, Picone, Simonetta, Tzialla, Chryssoula
Format: Article
Language:English
Subjects:
Analysis
Antibiotics
Asphyxia neonatorum
Bayesian analysis
Cloxacillin
Dalbavancin
Dosage
Health aspects
Infants (Newborn)
Mathematical models
Methicillin
Metronidazole
Minimum inhibitory concentration
model-informed precision dosing
Mortality
Neonates
Neonatology
Newborn babies
newborns
Optimization
Pediatric pharmacology
Pharmacodynamics
Pharmacokinetics
Premature babies
Premature birth
Technicians
therapeutic drug monitoring
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Summary:The selection of an appropriate dose of a given antibiotic for a neonate not only requires knowledge of the drug's basic pharmacokinetic (PK) and pharmacodynamic (PD) properties but also the profound effects that organ development might have on the volume of distribution and clearance, both of which may affect the PK/PD of a drug. Interest has grown in alternative antibiotic dosing strategies that are better aligned with the antibiotic's PK and PD properties. These strategies should be used in conjunction with minimum inhibitory concentration measurements and therapeutic drug monitoring to measure their potential success. They can also guide the clinician in tailoring the delivery of antibiotics to suit an individual patient's needs. Model-informed precision dosing, such as Bayesian forecasting dosing software (which incorporates PK/PD population models), may be utilized to optimize antibiotic exposure in neonatal populations. Consequently, optimizing the antibiotic dose and exposure in each newborn requires expertise in different fields. It drives the collaboration of physicians together with lab technicians and quantitative clinical pharmacologists.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12121747