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Clinical pharmacology of carbapenems in neonates

Gian Maria Pacifici, Karel Allegaert

    Journal of Chemotherapy (Florence, Italy)
    |October 5, 2013
    PubMed

    Insights

    Carbapenem antibiotics are crucial for treating serious bacterial infections in newborns. Current data is limited, but ongoing studies on meropenem and doripenem will improve treatment guidance.

    Area of Science:

    • Neonatal pharmacology
    • Infectious disease treatment
    • Antibiotic stewardship

    Background:

    • Carbapenems are vital for complicated bacterial infections.
    • Limited data exists on carbapenem use in neonates.
    • Understanding neonatal pharmacotherapy is crucial for effective treatment.

    Purpose of the Study:

    • To review current carbapenem information for neonates.
    • To guide clinicians in selecting appropriate carbapenems and indications.
    • To identify knowledge gaps for future research.

    Main Methods:

    • Bibliographic search of PubMed and EMBASE.
    • Searched clinical trial registries (clinicaltrials.gov, EU registry).
    • Focused on infant/newborn use of meropenem, imipenem, panipenem, ertapenem, doripenem.

    Main Results:

    • Carbapenem clearance is low in neonates, influenced by maturation and renal function.
    • Pharmacodynamic data is primarily available for meropenem.
    • Ongoing studies (NeoMero, doripenem PK) will expand knowledge.

    Conclusions:

    • Carbapenem data in neonates is scarce, but new studies are underway.
    • Meropenem is the current recommended choice off-label when carbapenems are needed.
    • Further research is needed on pharmacokinetics in renal failure and infusion duration.

    Keywords:
    Carbapenems,Doripenem,Imipenem,Meropenem,NeonatePanipenem,Pharmacokinetics,

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