Abstract | BACKGROUND & OBJECTIVES: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections. METHODS: Relevant research questions were identified. An extensive electronic and manual search methodology was used. Potentially eligible articles were screened for eligibility. The relevant data were extracted independently in a pre-specified data extraction form. Pooling of data was planned. RESULTS: INTERPRETATION & CONCLUSIONS: There is a wide knowledge gap for determining the doses of antimicrobials used for Gram-negative infections in neonates. A different profile of newborns in the developing countries could affect the disposition of antimicrobials for Gram negative infections, necessitating the generation of PK-PD data of antimicrobials in neonates from developing countries. Further, guidelines for treatment of neonatal conditions may incorporate the evidence-based PK-PD-guided dosing regimens.
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Authors | Nusrat Shafiq, Samir Malhotra, Vikas Gautam, Harpreet Kaur, Pravin Kumar, Sourabh Dutta, Pallab Ray, Nilima A Kshirsagar |
Journal | The Indian journal of medical research
(Indian J Med Res)
Vol. 145
Issue 3
Pg. 299-316
(Mar 2017)
ISSN: 0971-5916 [Print] India |
PMID | 28749392
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
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Topics |
- Anti-Bacterial Agents
(adverse effects, pharmacokinetics, therapeutic use)
- Dose-Response Relationship, Drug
- Drug Resistance, Multiple, Bacterial
(genetics)
- Gram-Negative Bacterial Infections
(drug therapy, epidemiology, microbiology)
- Humans
- Infant, Newborn
- Microbial Sensitivity Tests
- Pseudomonas aeruginosa
(drug effects, pathogenicity)
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