Pharmacokinetics of ticarcillin-clavulanate in premature infants.

Journal Article (Journal Article;Multicenter Study)

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.

Full Text

Duke Authors

Cited Authors

  • Watt, KM; Hornik, CP; Balevic, SJ; Mundakel, G; Cotten, CM; Harper, B; Benjamin, DK; Anand, R; Laughon, M; Smith, PB; Cohen-Wolkowiez, M; Best Pharmaceuticals for Children Act - Pediatric Trials Network Steering Committee,

Published Date

  • May 2019

Published In

Volume / Issue

  • 85 / 5

Start / End Page

  • 1021 - 1027

PubMed ID

  • 30710387

Pubmed Central ID

  • PMC6475694

Electronic International Standard Serial Number (EISSN)

  • 1365-2125

Digital Object Identifier (DOI)

  • 10.1111/bcp.13882


  • eng

Conference Location

  • England