Intestinal fatty-acid binding protein and metronidazole response in premature infants.

Published

Journal Article

In premature infants with suspected intra-abdominal infection, biomarkers for treatment response to antimicrobial therapy are lacking. Intestinal fatty acid-binding protein (I-FABP) is specific to the enterocyte and is released in response to intestinal mucosal injury. I-FABP has not been evaluated as a surrogate marker of disease response to antimicrobial therapy. We examined the relationship between metronidazole exposure and urinary I-FABP concentrations in premature infants with suspected intra-abdominal infection.We conducted an intravenous metronidazole pharmacokinetic study, collecting ≤3 urine samples per infant for I-FABP concentration measurements. We analyzed the relationship between I-FABP concentrations and measures of metronidazole exposure and pharmacokinetics, maturational factors, and other covariates.Twenty-six samples from 19 premature infants were obtained during metronidazole treatment. When analyzed without regard to presence of necrotic gastrointestinal disease, there were no significant associations between predictor variables and I-FABP concentrations. However, when the sample was limited to premature infants with necrotic gastrointestinal disease, an association was found between average predicted metronidazole concentration and I-FABP concentration (p = 0.006).While a predictive association between urinary I-FABP and metronidazole systemic exposure was not observed, the data suggest the potential of this endogenous biomarker to serve as a pharmacodynamic surrogate for antimicrobial treatment of serious abdominal infections in neonates and infants.

Full Text

Duke Authors

Cited Authors

  • Sampson, MR; Bloom, BT; Arrieta, A; Capparelli, E; Benjamin, DK; Smith, PB; Kearns, GL; van den Anker, J; Cohen-Wolkowiez, M

Published Date

  • January 2014

Published In

Volume / Issue

  • 7 / 3

Start / End Page

  • 223 - 228

PubMed ID

  • 25318626

Pubmed Central ID

  • 25318626

Electronic International Standard Serial Number (EISSN)

  • 1878-4429

International Standard Serial Number (ISSN)

  • 1934-5798

Digital Object Identifier (DOI)

  • 10.3233/NPM-1477013

Language

  • eng