[Dosing regimen rationalization of biapenem in pediatric patients: use of Monte Carlo simulation].

Abstract

Biapenem has been used in pediatric patients as well as adult patients; however, little information is available on dosing regimens for pediatric patients. This study examined biapenem pharmacokinetics in pediatric population and performed pharmacokinetic-pharmacodynamic analysis. Biapenem plasma concentrations from 10 pediatric patients were pharmacokinetically analyzed. A multi-regression analysis showed the pharmacokinetic parameters were affected by body weight and creatinine clearance of the patients. Using the pharmacokinetic parameters, a Monte Carlo simulation predicted the probabilities of attaining the pharmacodynamic target (40% of the time above the minimum inhibitory concentration for the bacterium). In the case of about 20 kg, biapenem regimens of 5 mg/kg b.i.d. and 10 mg/kg b.i.d. provided sufficient target attainment probabilities against Streptococcus pneumoniae and Pseudomonas aeruginosa isolates, respectively. Our results should provide a PK-PD-based guidance for rationalizing biapenem regimen according to the body weight and renal function of a pediatric patient and the specific bacterium suspected.

• Authors: Keiko Kameda, Mizuka Miki, Kazuro Ikawa, Norifumi Morikawa, Masao Kobayashi
• Journal: The Japanese journal of antibiotics (Jpn J Antibiot) Vol. 62 Issue 1 Pg. 1-8 (Feb 2009) ISSN: 0368-2781 [Print] Japan
• PMID: 19378765 (Publication Type: Journal Article)

Chemical References

• Anti-Infective Agents
• Thienamycins
• Creatinine
• biapenem

Topics

• Adolescent
• Anti-Infective Agents (administration & dosage, pharmacokinetics, pharmacology)
• Body Weight
• Child
• Child, Preschool
• Creatinine (urine)
• Drug Resistance, Bacterial
• Female
• Humans
• Male
• Metabolic Clearance Rate
• Models, Biological
• Monte Carlo Method
• Pseudomonas aeruginosa (drug effects)
• Regression Analysis
• Streptococcus pneumoniae (drug effects)
• Thienamycins (administration & dosage, pharmacokinetics, pharmacology)