Scholars@Duke

Cefazolin pharmacokinetics in premature infants.

Publication ,  Journal Article
Balevic, SJ; Smith, PB; Testoni, D; Wu, H; Brouwer, KLR; Zimmerman, KO; Rivera-Chaparro, ND; Benjamin, DK; Cohen-Wolkowiez, M
Published in: J Perinatol
September 2019
Published version (DOI) Link to item

OBJECTIVE: Pharmacokinetic (PK) data to guide cefazolin dosing in premature infants are virtually non-existent. Therefore, we aimed to characterize cefazolin PK in infants aged ≤32 weeks of gestation at birth. STUDY DESIGN: We conducted a prospective, open-label PK and safety study of cefazolin in infants ≤32 weeks gestation from a University Medical Center. We administered intravenous cefazolin and collected both timed and scavenged blood samples. We analyzed data using non-linear mixed effect modeling and simulated several dosage regimens to achieve target concentrations against methicillin-susceptible Staphylococcus aureus. RESULTS: We analyzed 40 samples from nine infants and observed that premature infants had lower clearance and greater volume of distribution for cefazolin compared to older children. The median (range) individual Bayesian estimates were 0.03 L/h/kg (0.01-0.08) for clearance and 0.39 L/kg (0.31-0.52) for volume. CONCLUSION: Simulations suggested reduced cefazolin dosing based on postmenstrual age achieve target concentrations and potentially reduce unnecessary exposure.

Duke Scholars

Stephen Joseph Balevic
Author Stephen Joseph Balevic Pediatrics, Rheumatology
Phillip Brian Smith
Author Phillip Brian Smith Pediatrics, Neonatology
Kanecia Obie Zimmerman
Author Kanecia Obie Zimmerman Pediatrics, Critical Care Medicine
Daniel Kelly Benjamin Jr.
Author Daniel Kelly Benjamin Jr. Pediatrics, Infectious Diseases
Michael Cohen-Wolkowiez
Author Michael Cohen-Wolkowiez Pediatrics, Infectious Diseases
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Published In

J Perinatol

DOI

10.1038/s41372-019-0368-z

EISSN

1476-5543

Publication Date

September 2019

Volume

39

Issue

9

Start / End Page

1213 / 1218

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Models, Biological
  • Male
  • Infant, Premature
  • Infant, Newborn
  • Humans
  • Gestational Age
  • Female
  • Datasets as Topic
 

Citation

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Balevic, S. J., Smith, P. B., Testoni, D., Wu, H., Brouwer, K. L. R., Zimmerman, K. O., … Cohen-Wolkowiez, M. (2019). Cefazolin pharmacokinetics in premature infants. J Perinatol, 39(9), 1213–1218. https://doi.org/10.1038/s41372-019-0368-z
Balevic, Stephen J., P Brian Smith, Daniela Testoni, Huali Wu, Kim L. R. Brouwer, Kanecia O. Zimmerman, Nazario D. Rivera-Chaparro, Daniel K. Benjamin, and Michael Cohen-Wolkowiez. “Cefazolin pharmacokinetics in premature infants.” J Perinatol 39, no. 9 (September 2019): 1213–18. https://doi.org/10.1038/s41372-019-0368-z.
Balevic SJ, Smith PB, Testoni D, Wu H, Brouwer KLR, Zimmerman KO, et al. Cefazolin pharmacokinetics in premature infants. J Perinatol. 2019 Sep;39(9):1213–8.
Balevic, Stephen J., et al. “Cefazolin pharmacokinetics in premature infants.” J Perinatol, vol. 39, no. 9, Sept. 2019, pp. 1213–18. Pubmed, doi:10.1038/s41372-019-0368-z.
Balevic SJ, Smith PB, Testoni D, Wu H, Brouwer KLR, Zimmerman KO, Rivera-Chaparro ND, Benjamin DK, Cohen-Wolkowiez M. Cefazolin pharmacokinetics in premature infants. J Perinatol. 2019 Sep;39(9):1213–1218.

Published In

J Perinatol

DOI

10.1038/s41372-019-0368-z

EISSN

1476-5543

Publication Date

September 2019

Volume

39

Issue

9

Start / End Page

1213 / 1218

Location

United States

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Models, Biological
  • Male
  • Infant, Premature
  • Infant, Newborn
  • Humans
  • Gestational Age
  • Female
  • Datasets as Topic