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Pharmacokinetics of imipenem/cilastatin sodium in children with peritonitis
G Claesson1, M Eriksson, J D Rogers
1Department of Paediatric Surgery, Karolinska Institute, St. Görans Hospital, Stockholm, Sweden.
Insights
Pediatric patients (3-12 years) receiving intravenous imipenem/cilastatin showed favorable pharmacokinetics. Drug accumulation was minimal, with levels similar to adults, supporting its use in children with peritonitis.
Area of Science:
- Pharmacology
- Pediatric Medicine
- Infectious Diseases
Background:
- Peritonitis in children requires effective antibiotic treatment.
- Imipenem/cilastatin is a broad-spectrum antibiotic combination used for severe infections.
Purpose of the Study:
- To evaluate the pharmacokinetics of imipenem/cilastatin in pediatric patients aged 3-12 years with peritonitis.
- To determine drug accumulation and compare pediatric pharmacokinetics to adult data.
Main Methods:
- Intravenous administration of imipenem/cilastatin (15 or 25 mg/kg) every six hours for 3-14 days.
- Collection of blood and urine samples over a six-hour dosing interval during days 2-8 of treatment.
- Analysis of imipenem and cilastatin plasma and urine concentrations.
Main Results:
- Urinary recovery of imipenem and cilastatin averaged 50-70% of the administered dose.
- Mean plasma half-life (t1/2) for imipenem was 55 minutes; for cilastatin, it was approximately 38 minutes.
- Little to no drug accumulation was observed, with steady-state conditions reached within 2 days.
Conclusions:
- The pharmacokinetic profile of imipenem/cilastatin in pediatric patients (3-12 years) is similar to that in adults.
- The studied intravenous dosing regimen appears safe and effective for treating peritonitis in this pediatric age group without significant accumulation.
Abstract:
Fifteen children (3-12 years) with peritonitis were given imipenem/cilastatin intravenously (15 or 25 mg/kg) every six hours for 3-14 days. One day during treatment days 2-8, multiple blood and urine samples were collected from each individual over a six hour dosing interval. Twelve children completed the study. The urinary recovery of imipenem and cilastatin averaged 50-70% of the administered dose. The plasma t1/2 for imipenem averaged 55 min. while that for cilastatin was even more rapid (approximately 38 min.). Little or no accumulation of either imipenem or cilastatin was observed for this regimen in this age group of paediatric patients. Steady state conditions prevailed within 2 days of initiation of therapy. The pharmacokinetics of imipenem and cilastatin in paediatric patients 3-12 years of age appear similar to those observed for adults.