Related Experiment Video

Updated: Aug 7, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Prospective determination of plasma imipenem concentrations in critically ill children

Eric Giannoni1, Philippe Moreillon, Jacques Cotting

  • 1Department of Pediatrics, CHUV, CH-1011 Lausanne, Switzerland.

Antimicrobial Agents and Chemotherapy
|June 28, 2006
PubMed

Insights

Critically ill children showed wide variations in imipenem plasma levels, leading to unpredictable drug concentrations. A minimum dose of 100 mg/kg/day is recommended to ensure effective treatment in this vulnerable population.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacokinetics
  • Infectious Diseases

Background:

  • Antibiotic dosing in critically ill children is challenging due to physiological changes.
  • Imipenem-cilastatin is a broad-spectrum antibiotic used for severe infections.

Purpose of the Study:

  • To measure plasma imipenem concentrations in critically ill children.
  • To assess the variability of imipenem levels and guide dosing recommendations.

Main Methods:

  • Plasma imipenem concentrations were measured in 19 critically ill children.
  • Patient age ranged from 0.02 to 12.9 years (median 0.8 years).

Main Results:

  • Significant interindividual variability in plasma imipenem concentrations was observed.
  • Peak concentrations varied 2-4 fold, and trough concentrations varied more than 10 fold.
  • Unpredictable plasma levels were noted in several pediatric patients.

Conclusions:

  • Standard imipenem dosing may lead to subtherapeutic levels in critically ill children.
  • A recommended minimum dose of 100 mg/kg/day of imipenem-cilastatin is suggested.
  • Optimized dosing is crucial for effective treatment of severe infections in pediatric critical care.

Related Concept Videos

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...