New antibiotic dosing in infants

Clin Perinatol. 2015 Mar;42(1):167-76, ix-x. doi: 10.1016/j.clp.2014.10.009. Epub 2014 Nov 27.

Abstract

To prevent the devastating consequences of infection, most infants admitted to the neonatal intensive care unit are exposed to antibiotics. However, dosing regimens are often extrapolated from data in adults and older children, increasing the risk for drug toxicity and lack of clinical efficacy because they fail to account for developmental changes in infant physiology. However, newer technologies are emerging with minimal-risk study designs, including ultra-low-volume assays, pharmacokinetic modeling and simulation, and opportunistic drug protocols. With minimal-risk study designs, pharmacokinetic data and dosing regimens for infants are now available for ampicillin, clindamycin, meropenem, metronidazole, and piperacillin/tazobactam.

Keywords: Antibiotics; Dosing; Infants; Neonates; Pharmacokinetics; Prematurity.

Publication types

  • Review

MeSH terms

  • Ampicillin / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Bacterial Infections / drug therapy*
  • Clindamycin / administration & dosage
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Meropenem
  • Metronidazole / administration & dosage
  • Penicillanic Acid / administration & dosage
  • Penicillanic Acid / analogs & derivatives
  • Piperacillin / administration & dosage
  • Piperacillin, Tazobactam Drug Combination
  • Practice Guidelines as Topic*
  • Thienamycins / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Metronidazole
  • Piperacillin, Tazobactam Drug Combination
  • Clindamycin
  • Ampicillin
  • Penicillanic Acid
  • Meropenem
  • Piperacillin