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Pharmacokinetics of Antibiotics in Pediatric Intensive Care: Fostering Variability to Attain Precision Medicine
- Source :
- Antibiotics, Antibiotics, Vol 10, Iss 1182, p 1182 (2021)
- Publication Year :
- 2021
- Publisher :
- MDPI, 2021.
-
Abstract
- Children show important developmental and maturational changes, which may contribute greatly to pharmacokinetic (PK) variability observed in pediatric patients. These PK alterations are further enhanced by disease-related, non-maturational factors. Specific to the intensive care setting, such factors include critical illness, inflammatory status, augmented renal clearance (ARC), as well as therapeutic interventions (e.g., extracorporeal organ support systems or whole-body hypothermia [WBH]). This narrative review illustrates the relevance of both maturational and non-maturational changes in absorption, distribution, metabolism, and excretion (ADME) applied to antibiotics. It hereby provides a focused assessment of the available literature on the impact of critical illness-in general, and in specific subpopulations (ARC, extracorporeal organ support systems, WBH)-on PK and potential underexposure in children and neonates. Overall, literature discussing antibiotic PK alterations in pediatric intensive care is scarce. Most studies describe antibiotics commonly monitored in clinical practice such as vancomycin and aminoglycosides. Because of the large PK variability, therapeutic drug monitoring, further extended to other antibiotics, and integration of model-informed precision dosing in clinical practice are suggested to optimise antibiotic dose and exposure in each newborn, infant, or child during intensive care. ispartof: ANTIBIOTICS-BASEL vol:10 issue:10 ispartof: location:Switzerland status: published
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
augmented renal clearance
medicine.drug_class
medicine.medical_treatment
therapeutic drug monitoring
Antibiotics
continuous renal replacement therapy
RM1-950
Review
Biochemistry
Microbiology
Pharmacokinetics
SDG 3 - Good Health and Well-being
Intensive care
antibiotic
medicine
Extracorporeal membrane oxygenation
critical illness
Pharmacology (medical)
Dosing
General Pharmacology, Toxicology and Pharmaceutics
Intensive care medicine
medicine.diagnostic_test
business.industry
extracorporeal membrane oxygenation
Precision medicine
Infectious Diseases
pediatric
whole body hypothermia
Therapeutic drug monitoring
Vancomycin
Therapeutics. Pharmacology
business
cardiopulmonary bypass
pharmacokinetics
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Antibiotics, Antibiotics, Vol 10, Iss 1182, p 1182 (2021)
- Accession number :
- edsair.doi.dedup.....ed179540ed1cf0952f25b8d57b68a4b4