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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

395
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
395
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

391
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
391
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

328
Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
328
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

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

377
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...
377
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

972
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...
972
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

532
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,...
532

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Optimizing therapy for vancomycin-resistant enterococcal bacteremia in children.

Pranita D Tamma1, Alice J Hsu

  • 1aDivision of Pediatric Infectious Diseases, Department of Pediatrics, The Johns Hopkins University School of Medicine bDepartment of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

Current Opinion in Infectious Diseases
|October 15, 2014
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Summary
This summary is machine-generated.

Linezolid is a versatile treatment for vancomycin-resistant enterococcal (VRE) bloodstream infections in children, showing favorable outcomes and oral administration options. It is recommended as a first-line therapy despite potential toxicities with prolonged use.

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Area of Science:

  • Infectious Diseases
  • Pediatric Pharmacology
  • Antimicrobial Therapy

Background:

  • Vancomycin-resistant enterococcal (VRE) bloodstream infections present treatment challenges, especially when ampicillin is contraindicated.
  • Key therapeutic options include quinupristin-dalfopristin, linezolid, and daptomycin, with linezolid holding specific FDA approval for VRE bacteremia.

Purpose of the Study:

  • To compare the efficacy, dosing, and side-effect profiles of quinupristin-dalfopristin, linezolid, and daptomycin for VRE bacteremia in pediatric patients.
  • To provide an overview of emerging broad-spectrum Gram-positive agents for potential future VRE management.

Main Methods:

  • Comparative review of existing literature on quinupristin-dalfopristin, linezolid, and daptomycin for VRE bacteremia.
  • Analysis of clinical trial data and meta-analyses focusing on pediatric populations.
  • Inclusion of pharmacokinetic data and safety profiles for each agent.

Main Results:

  • Linezolid demonstrates broad-spectrum activity against both Enterococcus faecalis and E. faecium, with favorable outcomes noted in meta-analyses compared to daptomycin.
  • Linezolid offers the advantage of oral administration and appears to have lower rates of resistance development compared to other agents.
  • While effective, linezolid's prolonged use is associated with toxicities, and its clinical pharmacokinetics in children are well-documented.

Conclusions:

  • Linezolid is considered the most versatile agent for VRE bacteremia in children due to its spectrum of activity, oral option, and lower resistance concerns.
  • Despite potential toxicities with extended use, linezolid is favored as first-line therapy for pediatric VRE bacteremia pending further prospective data.
  • Further research into newer agents and long-term safety profiles is warranted for comprehensive VRE management strategies.