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Population Pharmacokinetics of Moxifloxacin in Children.

Publication ,  Journal Article
Greenberg, RG; Landersdorfer, CB; Rivera-Chaparro, N; Harward, M; Conrad, T; Nakamura, A; Kirkpatrick, CM; Gu, K; Ghazaryhan, V; Osborn, B; Walter, EB
Published in: Paediatr Drugs
March 2022

BACKGROUND/OBJECTIVE: Moxifloxacin is a fluoroquinolone that is commonly used in adults, but not children. Certain clinical situations compel pediatric clinicians to use moxifloxacin, despite its potential for toxicity and limited pharmacokinetics (PK) data. Our objective was to further characterize the pharmacokinetics of moxifloxacin in children. METHODS: We performed an opportunistic, open-label population PK study of moxifloxacin in children < 18 years of age who received moxifloxacin as part of standard care. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling. Covariates with known biological relationships were investigated for their influence on PK parameters. RESULTS: We obtained 43 moxifloxacin concentrations from 14 participants who received moxifloxacin intravenously (n = 8) or orally (n = 6). The dose of moxifloxacin was 10 mg/kg daily in participants ≤ 40 kg and 400 mg daily in participants > 40 kg. The population mean clearance and mean volume of distribution were 18.2 L/h and 167 L, respectively. The oral absorption was described by a first-order process. The estimated extent of oral bioavailability was highly variable (range 20-91%). Total body weight was identified as a covariate on clearance and volume of distribution, and substantially reduced the random unexplained inter-individual variability for both parameters. No participants experienced suspected serious adverse reactions related to moxifloxacin. CONCLUSION: These data add to the existing literature to support use of moxifloxacin in children in certain situations; however, further prospective studies on the safety and efficacy of moxifloxacin are needed.

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Published In

Paediatr Drugs

DOI

EISSN

1179-2019

Publication Date

March 2022

Volume

24

Issue

2

Start / End Page

163 / 173

Location

Switzerland

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Moxifloxacin
  • Humans
  • Child
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 3213 Paediatrics
  • 1115 Pharmacology and Pharmaceutical Sciences
  • 1114 Paediatrics and Reproductive Medicine
 

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Greenberg, R. G., Landersdorfer, C. B., Rivera-Chaparro, N., Harward, M., Conrad, T., Nakamura, A., … Walter, E. B. (2022). Population Pharmacokinetics of Moxifloxacin in Children. Paediatr Drugs, 24(2), 163–173. https://doi.org/10.1007/s40272-022-00493-3
Greenberg, Rachel G., Cornelia B. Landersdorfer, Nazario Rivera-Chaparro, Melissa Harward, Thomas Conrad, Aya Nakamura, Carl M. Kirkpatrick, et al. “Population Pharmacokinetics of Moxifloxacin in Children.Paediatr Drugs 24, no. 2 (March 2022): 163–73. https://doi.org/10.1007/s40272-022-00493-3.
Greenberg RG, Landersdorfer CB, Rivera-Chaparro N, Harward M, Conrad T, Nakamura A, et al. Population Pharmacokinetics of Moxifloxacin in Children. Paediatr Drugs. 2022 Mar;24(2):163–73.
Greenberg, Rachel G., et al. “Population Pharmacokinetics of Moxifloxacin in Children.Paediatr Drugs, vol. 24, no. 2, Mar. 2022, pp. 163–73. Pubmed, doi:10.1007/s40272-022-00493-3.
Greenberg RG, Landersdorfer CB, Rivera-Chaparro N, Harward M, Conrad T, Nakamura A, Kirkpatrick CM, Gu K, Ghazaryhan V, Osborn B, Walter EB. Population Pharmacokinetics of Moxifloxacin in Children. Paediatr Drugs. 2022 Mar;24(2):163–173.
Journal cover image

Published In

Paediatr Drugs

DOI

EISSN

1179-2019

Publication Date

March 2022

Volume

24

Issue

2

Start / End Page

163 / 173

Location

Switzerland

Related Subject Headings

  • Prospective Studies
  • Pediatrics
  • Moxifloxacin
  • Humans
  • Child
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 3213 Paediatrics
  • 1115 Pharmacology and Pharmaceutical Sciences
  • 1114 Paediatrics and Reproductive Medicine