Population pharmacokinetics and dose optimization of piperacillin-tazobactam in premature and term neonates with severe infections
Frida S. Boer-Pérez, Victoria Lima-Rogel, Silvia Romano-Moreno, Ana R. Mejía-Elizondo, Susanna E. Medellín-Garibay, Paula Schaiquevich, Daniel E. Noyola-Cherpitel, Ana S. Rodríguez-Báez, Cristian J. Rodríguez-Pinal, Rosa del C. Milán-Segovia
TL;DR
This study develops a model to optimize piperacillin-tazobactam dosing in neonates based on their kidney function and developmental stage.
Contribution
A validated pharmacokinetic model for neonates to guide individualized dosing of piperacillin-tazobactam.
Findings
A one-compartment model best described piperacillin pharmacokinetics in neonates.
Preterm neonates are at high risk of overexposure with current dosing recommendations.
Extended infusions may improve target attainment for less-susceptible pathogens.
Abstract
Piperacillin-tazobactam is widely used off-label in neonates for the empirical treatment of severe infections, resulting in diverse dosing regimens across clinical settings. This variability, combined with high interindividual differences in renal maturation that impact drug disposition, complicates standardized dosing and emphasizes the need for individualized, evidence-based strategies. This study aimed to develop and evaluate a population pharmacokinetic model of piperacillin in neonates to support optimized initial dosing recommendations. Neonatal patients (postnatal age ≤28 days) admitted to an intensive care unit who received piperacillin-tazobactam (8:1 ratio) at Neofax-recommended doses were included. Plasma concentrations were measured using an ultra-high-performance liquid chromatography with tandem mass spectrometry method. Population pharmacokinetic analysis for piperacillin…
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Taxonomy
TopicsAntibiotics Pharmacokinetics and Efficacy · Pharmaceutical studies and practices · Neonatal and Maternal Infections