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Developmental pharmacology and therapeutics of piperacillin in gram-negative infections
Insights
Piperacillin effectively treats bacterial infections in children, with serum concentrations correlating to dosage. Age influences piperacillin
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Clinical Pharmacy
Background:
- Bacterial infections are common in children.
- Understanding drug pharmacokinetics is crucial for effective treatment.
Purpose of the Study:
- To evaluate piperacillin pharmacokinetics in pediatric patients.
- To assess piperacillin's efficacy and safety in treating non-central nervous system bacterial infections in children.
Main Methods:
- Noncompartmental pharmacokinetic analysis was performed on 15 children.
- Piperacillin serum concentrations were measured after first dose and at steady-state.
- Correlation between dose and peak serum concentration was analyzed.
Main Results:
- Peak piperacillin serum concentrations ranged from 51 to 232 mg/l, directly correlating with dose (r=0.75).
- Age-dependent decreases in elimination half-life and volume of distribution were observed in children with normal renal function.
- Piperacillin therapy showed favorable response in most children, with no observed adverse effects.
Conclusions:
- Piperacillin demonstrates predictable pharmacokinetics and favorable safety profile in pediatric patients.
- Age influences piperacillin's pharmacokinetic parameters in children.
- Piperacillin is an effective treatment option for pediatric bacterial infections, though pathogen eradication should be monitored.
Abstract:
Twenty children ranging in age from 1 week to 19 years with documented or suspected bacterial infections arising outside the central nervous system were studied. Pharmacokinetic analysis was possible in 15 children; 8 after the first dose, 6 during steady-state conditions, and 4 on both occasions. Data were obtained utilizing noncompartmental pharmacokinetic methods. Peak piperacillin serum concentrations ranged from 51 to 232 mg/l and correlated directly (r = 0.75) with the dose administered. In children with normal renal function, there was an age-dependent decrease in elimination half-life and apparent steady-state volume of distribution, whereas plasma clearance increased logarithmically. All but 1 child responded favorably to piperacillin therapy, and 1 child with a urinary tract infection relapsed 10 days after discontinuation of the therapy. Although improved clinically, piperacillin monotherapy failed to eradicate pathogens in 2 children. No adverse clinical or biochemical effects were observed in any child.