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Pharmacokinetics of meropenem in preterm neonates
J G van Enk1, D J Touw, H N Lafeber
1Departments of Neonatology and Pharmacy, VU Medical Center, Amsterdam, Netherlands.
Insights
Meropenem dosing in premature neonates is safe and effective. Pharmacokinetics support twice-daily administration of 15 mg/kg meropenem, ensuring adequate serum concentrations with a 1-minute infusion.
Area of Science:
- Neonatal pharmacology
- Pediatric pharmacokinetics
- Infectious disease treatment
Background:
- Meropenem is a broad-spectrum antibiotic used for serious bacterial infections.
- Optimizing meropenem dosage in premature neonates is crucial due to their immature organ systems.
- Understanding meropenem pharmacokinetics is essential for safe and effective treatment in this vulnerable population.
Purpose of the Study:
- To evaluate and compare meropenem pharmacokinetics in premature neonates after the first dose and at steady state on day 5.
- To assess the feasibility of twice-daily meropenem administration.
- To determine if a 1-minute intravenous infusion is suitable for meropenem delivery.
Main Methods:
- Seven premature neonates received 15 mg/kg meropenem twice daily via 1-minute intravenous infusion.
- Serum meropenem levels were measured for 12 hours post-administration after the first dose and on day 5.
- Pharmacokinetic parameters were analyzed using a one-compartment model.
Main Results:
- Meropenem pharmacokinetics were characterized by a mean total body clearance of 0.157 L/kg/hr, volume of distribution of 0.74 L/kg, and half-life of 3.4 hours.
- Pharmacokinetic properties remained consistent between the first dose and steady state on day 5.
- No adverse effects were observed during the study.
Conclusions:
- A 1-minute intravenous administration of meropenem is feasible in premature neonates.
- Twice-daily administration of 15 mg/kg meropenem achieves adequate serum concentrations.
- Meropenem demonstrates predictable pharmacokinetics in premature neonates, supporting its use in this population.
Abstract:
The objective of this study was to evaluate and compare the pharmacokinetics of meropenem in premature neonates, both after the first dose and during steady state at day 5, after a 1-minute intravenous administration to evaluate the possibility of twice-daily administration. Seven premature neonates received 15 mg/kg meropenem twice daily on clinical grounds as a 1-minute infusion. After the first dose and during steady state at day 5, serum levels of meropenem were measured for 12 hours after intravenous administration. Meropenem pharmacokinetics at the first dose were studied in seven children (mean birth weight 925 g, mean postnatal age 21 days). Serum concentration-time curves could be described with a one-compartment model. Mean total body clearance was 0.157 L/kg per hour, volume of distribution was 0.74 L/kg, and half-life was 3.4 hours. At day 5 at steady state, pharmacokinetic properties did not differ significantly. No side effects were noted. A 1-minute intravenous administration is feasible. Pharmacokinetic properties are comparable at day 5 compared with the first dose, and half-life is such that twice-daily administration of 15 mg/kg produces adequate serum concentrations.