Population pharmacokinetics of intravenous and oral ciprofloxacin in children to optimize dosing regimens
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: This study aimed to characterize pharmacokinetics of intravenous and oral ciprofloxacin in children to optimize dosing scheme.
METHODS: Children treated with ciprofloxacin were included. Pharmacokinetics were described using non-linear mixed-effect modelling and validated with an external dataset. Monte Carlo simulations investigated dosing regimens to achieve a target AUC0-24 h/MIC ratio ≥ 125.
RESULTS: A total of 189 children (492 concentrations) were included. A two-compartment model with first-order absorption and elimination best described the data. An allometric model was used to describe bodyweight (BW) influence, and effects of estimated glomerular filtration rate (eGFR) and age were significant on ciprofloxacin clearance.
CONCLUSION: The recommended IV dose of 10 mg/kg q8h, not exceeding 400 mg q8h, would achieve AUC0-24 h to successfully treat bacteria with MICs ≤ 0.25 (e.g. Salmonella, Escherichia coli, Proteus, Haemophilus, Enterobacter, and Klebsiella). A dose increase to 600 mg q8h in children > 40 kg and to 15 mg/kg q8h (max 400 mg q8h, max 600 mg q8h if augmented renal clearance, i.e., eGFR > 200 mL/min/1.73 m2) in children < 40 kg would be needed for the strains with highest MIC (16% of Pseudomonas aeruginosa and 47% of Staphylococcus aureus). The oral recommended dose of 20 mg/kg q12h (not exceeding 750 mg) would cover bacteria with MICs ≤ 0.125 but may be insufficient for bacteria with higher MIC and a dose increase according bodyweight and eGFR would be needed. These doses should be prospectively confirmed, and a therapeutic drug monitoring could be used to refine them individually.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
|---|---|
| Enthalten in: |
European journal of clinical pharmacology - 77(2021), 11 vom: 09. Nov., Seite 1687-1695 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hirt, D [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
5E8K9I0O4U |
|---|
| Anmerkungen: |
Date Completed 02.02.2022 Date Revised 02.02.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00228-021-03174-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM32707955X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM32707955X | ||
| 003 | DE-627 | ||
| 005 | 20231225200000.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00228-021-03174-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1090.xml |
| 035 | |a (DE-627)NLM32707955X | ||
| 035 | |a (NLM)34160669 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hirt, D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Population pharmacokinetics of intravenous and oral ciprofloxacin in children to optimize dosing regimens |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.02.2022 | ||
| 500 | |a Date Revised 02.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: This study aimed to characterize pharmacokinetics of intravenous and oral ciprofloxacin in children to optimize dosing scheme | ||
| 520 | |a METHODS: Children treated with ciprofloxacin were included. Pharmacokinetics were described using non-linear mixed-effect modelling and validated with an external dataset. Monte Carlo simulations investigated dosing regimens to achieve a target AUC0-24 h/MIC ratio ≥ 125 | ||
| 520 | |a RESULTS: A total of 189 children (492 concentrations) were included. A two-compartment model with first-order absorption and elimination best described the data. An allometric model was used to describe bodyweight (BW) influence, and effects of estimated glomerular filtration rate (eGFR) and age were significant on ciprofloxacin clearance | ||
| 520 | |a CONCLUSION: The recommended IV dose of 10 mg/kg q8h, not exceeding 400 mg q8h, would achieve AUC0-24 h to successfully treat bacteria with MICs ≤ 0.25 (e.g. Salmonella, Escherichia coli, Proteus, Haemophilus, Enterobacter, and Klebsiella). A dose increase to 600 mg q8h in children > 40 kg and to 15 mg/kg q8h (max 400 mg q8h, max 600 mg q8h if augmented renal clearance, i.e., eGFR > 200 mL/min/1.73 m2) in children < 40 kg would be needed for the strains with highest MIC (16% of Pseudomonas aeruginosa and 47% of Staphylococcus aureus). The oral recommended dose of 20 mg/kg q12h (not exceeding 750 mg) would cover bacteria with MICs ≤ 0.125 but may be insufficient for bacteria with higher MIC and a dose increase according bodyweight and eGFR would be needed. These doses should be prospectively confirmed, and a therapeutic drug monitoring could be used to refine them individually | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Children | |
| 650 | 4 | |a Ciprofloxacin | |
| 650 | 4 | |a Dose optimization | |
| 650 | 4 | |a Population pharmacokinetics | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Ciprofloxacin |2 NLM | |
| 650 | 7 | |a 5E8K9I0O4U |2 NLM | |
| 650 | 7 | |a Creatinine |2 NLM | |
| 650 | 7 | |a AYI8EX34EU |2 NLM | |
| 700 | 1 | |a Oualha, M |e verfasserin |4 aut | |
| 700 | 1 | |a Pasquiers, B |e verfasserin |4 aut | |
| 700 | 1 | |a Blanot, S |e verfasserin |4 aut | |
| 700 | 1 | |a Rubinstazjn, R |e verfasserin |4 aut | |
| 700 | 1 | |a Glorion, C |e verfasserin |4 aut | |
| 700 | 1 | |a Messaoudi, S El |e verfasserin |4 aut | |
| 700 | 1 | |a Drummond, D |e verfasserin |4 aut | |
| 700 | 1 | |a Lopez, V |e verfasserin |4 aut | |
| 700 | 1 | |a Toubiana, J |e verfasserin |4 aut | |
| 700 | 1 | |a Béranger, A |e verfasserin |4 aut | |
| 700 | 1 | |a Boujaafar, Sana |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Capito, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Winter, S |e verfasserin |4 aut | |
| 700 | 1 | |a Léger, P L |e verfasserin |4 aut | |
| 700 | 1 | |a Berthaud, R |e verfasserin |4 aut | |
| 700 | 1 | |a Gana, Inès |e verfasserin |4 aut | |
| 700 | 1 | |a Foissac, F |e verfasserin |4 aut | |
| 700 | 1 | |a Tréluyer, J M |e verfasserin |4 aut | |
| 700 | 1 | |a Bouazza, N |e verfasserin |4 aut | |
| 700 | 1 | |a Benaboud, S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of clinical pharmacology |d 1971 |g 77(2021), 11 vom: 09. Nov., Seite 1687-1695 |w (DE-627)NLM000099538 |x 1432-1041 |7 nnns |
| 773 | 1 | 8 | |g volume:77 |g year:2021 |g number:11 |g day:09 |g month:11 |g pages:1687-1695 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00228-021-03174-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 77 |j 2021 |e 11 |b 09 |c 11 |h 1687-1695 | ||