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Updated: Oct 8, 2025

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

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The Pharmacokinetics of Beta-Lactam Antibiotics Using Scavenged Samples in Pediatric Intensive Care Patients: The

Stef Schouwenburg1, Enno D Wildschut2, M de Hoog2

  • 1Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.

Frontiers in Pharmacology
|December 27, 2021
PubMed

Insights

Optimizing antibiotic dosing in pediatric intensive care units (PICUs) is crucial. The EXPAT Kids study investigates if current beta-lactam antibiotic regimens achieve therapeutic targets in critically ill children, exploring novel sampling methods.

Area of Science:

  • Pediatric Intensive Care
  • Pharmacokinetics and Pharmacodynamics
  • Infectious Diseases

Background:

  • Optimized antibiotic exposure is vital for pediatric intensive care unit (PICU) patients.
  • Traditional dosing strategies are inadequate due to extreme pharmacokinetic variability in PICU populations.
  • Scavenged sampling offers a potential method for routine therapeutic drug monitoring (TDM) and biomarker research.

Purpose of the Study:

  • To evaluate if current empiric dosing of beta-lactam antibiotics achieves therapeutic targets in PICU patients.
  • To analyze the pharmacokinetic and pharmacodynamic profiles of commonly used beta-lactams in critically ill children.
  • To assess the feasibility of using scavenged samples for antibiotic exposure quantification.

Main Methods:

  • A single-center, exploratory pharmacokinetic and pharmacodynamic study.
  • Inclusion of 140 pediatric patients over 24 months.
  • Measurement of serum antibiotic concentrations (cefotaxime, ceftazidime, ceftriaxone, cefuroxime, flucloxacillin, meropenem) at various time points.
  • Validation of scavenged heparinized astrup syringes for antibiotic quantification.

Main Results:

  • Primary outcome: time above minimum inhibitory concentration (100%ƒT > MIC and 100%ƒT>4xMIC).
  • Secondary outcomes include disease severity, safety, length of stay, and inflammatory biomarkers.
  • Data will provide insights into beta-lactam PK parameters and target attainment.

Conclusions:

  • Findings will inform optimal beta-lactam dosing strategies in PICU patients.
  • Scavenged sampling may reduce blood draw workload and enhance data collection.
  • The study addresses the need for precise antibiotic dosing in critically ill children.

Keywords:
antibioticsbeta-lactamchildrencriticial illnesspharmacodynamicspharmacokinetics

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