Premium
Pharmacokinetics of ticarcillin–clavulanate in premature infants
Author(s) -
Watt Kevin M.,
Hornik Christoph P.,
Balevic Stephen J.,
Mundakel Gratias,
Cotten C. Michael,
Harper Barrie,
Benjamin Daniel K.,
Anand Ravinder,
Laughon Matthew,
Smith P. Brian,
CohenWolkowiez Michael
Publication year - 2019
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13882
Subject(s) - dosing , pharmacokinetics , gestational age , ticarcillin , medicine , minimum inhibitory concentration , pharmacology , gastroenterology , anesthesia , antibiotics , biology , pregnancy , clavulanic acid , microbiology and biotechnology , amoxicillin , genetics
Ticarcillin–clavulanate covers a broad spectrum of pathogens that are common in premature infants. In infants <30 weeks gestational age, pharmacokinetic data to guide ticarcillin–clavulanate dosing are lacking. We enrolled 15 premature infants <30 weeks gestational age, determined pharmacokinetic parameters, and performed dosing simulations to determine optimal dosing for ticarcillin–clavulanate. The infants had a median (range) postnatal age (PNA) of 18 days (6–44 days) and gestational age of 25 weeks (23–28 weeks). Clearance was lower in infants with a PNA <14 days (0.050 L/kg/h [range 0.043–0.075]) compared with a PNA ≥14–45 days (0.078 L/kg/h [0.047–0.100]), consistent with maturation of renal function. Dosing simulations determined that ticarcillin 75 mg/kg q12h (PNA <14 days) or q8h (PNA ≥ 14–45 days) achieved the target exposure for organisms with a minimum inhibitory concentration ≤16 μ/mL in >90% of simulated infants. For highly resistant organisms (minimum inhibitory concentration 32 μg/mL), increased dosing frequency or extended infusion are necessary.