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Pharmacokinetics of ticarcillin-clavulanate in premature infants.

Publication ,  Journal Article
Watt, KM; Hornik, CP; Balevic, SJ; Mundakel, G; Cotten, CM; Harper, B; Benjamin, DK; Anand, R; Laughon, M; Smith, PB; Cohen-Wolkowiez, M ...
Published in: Br J Clin Pharmacol
May 2019

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.

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Published In

Br J Clin Pharmacol

DOI

EISSN

1365-2125

Publication Date

May 2019

Volume

85

Issue

5

Start / End Page

1021 / 1027

Location

England

Related Subject Headings

  • beta-Lactamase Inhibitors
  • Ticarcillin
  • Staphylococcus
  • Staphylococcal Infections
  • Prospective Studies
  • Pharmacology & Pharmacy
  • Models, Biological
  • Microbial Sensitivity Tests
  • Male
  • Infant, Newborn
 

Citation

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Watt, K. M., Hornik, C. P., Balevic, S. J., Mundakel, G., Cotten, C. M., Harper, B., … Best Pharmaceuticals for Children Act - Pediatric Trials Network Steering Committee, . (2019). Pharmacokinetics of ticarcillin-clavulanate in premature infants. Br J Clin Pharmacol, 85(5), 1021–1027. https://doi.org/10.1111/bcp.13882
Watt, Kevin M., Christoph P. Hornik, Stephen J. Balevic, Gratias Mundakel, C Michael Cotten, Barrie Harper, Daniel K. Benjamin, et al. “Pharmacokinetics of ticarcillin-clavulanate in premature infants.Br J Clin Pharmacol 85, no. 5 (May 2019): 1021–27. https://doi.org/10.1111/bcp.13882.
Watt KM, Hornik CP, Balevic SJ, Mundakel G, Cotten CM, Harper B, et al. Pharmacokinetics of ticarcillin-clavulanate in premature infants. Br J Clin Pharmacol. 2019 May;85(5):1021–7.
Watt, Kevin M., et al. “Pharmacokinetics of ticarcillin-clavulanate in premature infants.Br J Clin Pharmacol, vol. 85, no. 5, May 2019, pp. 1021–27. Pubmed, doi:10.1111/bcp.13882.
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. Pharmacokinetics of ticarcillin-clavulanate in premature infants. Br J Clin Pharmacol. 2019 May;85(5):1021–1027.
Journal cover image

Published In

Br J Clin Pharmacol

DOI

EISSN

1365-2125

Publication Date

May 2019

Volume

85

Issue

5

Start / End Page

1021 / 1027

Location

England

Related Subject Headings

  • beta-Lactamase Inhibitors
  • Ticarcillin
  • Staphylococcus
  • Staphylococcal Infections
  • Prospective Studies
  • Pharmacology & Pharmacy
  • Models, Biological
  • Microbial Sensitivity Tests
  • Male
  • Infant, Newborn