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Population pharmacokinetics of cefepime in the neonate

Edmund Capparelli1, Christine Hochwald, Maynard Rasmussen

  • 1Pediatric Pharmacology Research Unit, University of California, 4094 4th Avenue, Suite 201, San Diego, California 92103, USA. ecapparelli@ucsd.edu

Antimicrobial Agents and Chemotherapy
|June 28, 2005
PubMed

Insights

This study optimized cefepime dosing for neonatal intensive care unit infants, finding a 30 mg/kg every 12-hour dose effective for neonates under 14 days old.

Area of Science:

  • Neonatal pharmacology
  • Infectious disease management
  • Pediatric pharmacokinetics

Background:

  • Neonatal intensive care unit (NICU) infants are susceptible to nosocomial infections.
  • Cefepime offers broad-spectrum activity against resistant gram-negative pathogens.
  • Optimizing cefepime dosing is crucial for efficacy and safety in neonates.

Purpose of the Study:

  • To determine cefepime pharmacokinetics in premature and term infants (<4 months).
  • To establish optimal cefepime dosing regimens for neonatal populations.
  • To minimize potential adverse events associated with cefepime treatment.

Main Methods:

  • Population pharmacokinetic (PK) analysis using NONMEM.
  • Limited PK sampling in 55 infants (<4 months) after a 50 mg/kg cefepime dose.
  • PK model development incorporating gestational and postnatal age, and serum creatinine.

Main Results:

  • Cefepime clearance (CL) strongly correlated with serum creatinine (SCr).
  • Volume of distribution varied significantly with postconceptional age (<30 vs. >30 weeks).
  • A 30 mg/kg every 12-hour dose for infants <14 days predicted adequate antibiotic exposure.

Conclusions:

  • The developed PK model accurately describes cefepime disposition in neonates.
  • A cefepime dose of 30 mg/kg every 12 hours is recommended for infants <14 days.
  • This optimized dosing strategy ensures effective antibiotic exposure in vulnerable neonatal populations.

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