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Population pharmacokinetics and pharmacodynamics of meropenem in Japanese pediatric patients

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Journal of Infection and Chemotherapy

Abstract

The aims of this study were to develop a population pharmacokinetic model for meropenem in Japanese pediatric patients, and to use this model to assess the pharmacodynamics of meropenem regimens against common bacterial populations. Pharmacokinetic data were pooled from nine separate studies (229 plasma samples and 61 urine samples from 40 infected children), modeled using the NONMEM program, and used for a pharmacodynamic simulation to estimate the probabilities of attaining the bactericidal target (40% of the time above the MIC for the bacterium). In the final population pharmacokinetic model, body weight (BW, kg) was the most significant covariate: Clr (l/h) = 0.254 × BW, Clnr (l/h) = 3.45, V c (l) = 0.272 × BW, Q (l/h) = 1.65, and V p (l) = 0.228 × BW, where Clr and Clnr are the renal and non-renal clearances, V p and V c are the volumes of distribution of the central and peripheral compartments, and Q is the intercompartmental (central–peripheral) clearance. In most typical patients (BW = 10, 20, and 30 kg), the approved regimens of 10–40 mg/kg, three times a day (0.5-h infusions), achieved a target attainment probability of >80% against Escherichia coli, Streptococcus pneumoniae, methicillin-susceptible Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa isolates. The results of this study provide a better understanding of the pharmacokinetics and pharmacodynamics of meropenem in Japanese pediatric patients.

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References

  1. Perez-Ruixo JJ, Zannikos P, Hirankarn S, Stuyckens K, Ludwig EA, Soto-Matos A, et al. Population pharmacokinetic meta-analysis of trabectedin (ET-743, Yondelis) in cancer patients. Clin Pharmacokinet. 2007;46:867–84.

    Article  CAS  PubMed  Google Scholar 

  2. Chan PL, Weatherley B, McFadyen L. A population pharmacokinetic meta-analysis of maraviroc in healthy volunteers and asymptomatic HIV-infected subjects. Br J Clin Pharmacol. 2008;65(Suppl 1):76–85.

    Article  CAS  PubMed  Google Scholar 

  3. Nicolau DP. Pharmacokinetic and pharmacodynamic properties of meropenem. Clin Infect Dis. 2008;47(Suppl 1):S32–40.

    Article  CAS  PubMed  Google Scholar 

  4. Fujita K, Murono K, Saijyo M, Yoshioka H, Maruyama S, Sakata H, et al. Clinical and pharmacokinetic evaluation of meropenem and its effect on fecal flora in children. Jpn J Antibiot. 1992;45:718–26.

    CAS  PubMed  Google Scholar 

  5. Tsutsumi H, Chiba S. Clinical pharmacology and efficacy of meropenem. Jpn J Antibiot. 1992;45:727–33.

    CAS  PubMed  Google Scholar 

  6. Tajima T, Negishi S, Kondo Y, Nishimura S, Higa A, Hagiwara N, et al. Pharmacokinetic, bacteriological and clinical studies on meropenem in children. Jpn J Antibiot. 1992;45:826–32.

    CAS  PubMed  Google Scholar 

  7. Niinou K, Sato H, Nakazawa S. Studies of meropenem in pediatric infections. Jpn J Antibiot. 1992;45:833–44.

    CAS  PubMed  Google Scholar 

  8. Toyonaga Y, Yamori K, Hatakeyama K, Ishihara T, Kawamura K, Seo K, et al. Pharmacokinetic and clinical studies on meropenem. Jpn J Antibiot. 1992;45:850–65.

    CAS  PubMed  Google Scholar 

  9. Meguro H, Mori A, Fujii R, Terashima I, Kurosaki T, Toba T, et al. Clinical evaluation of a new carbapenem, meropenem, in infants and children. Jpn J Antibiot. 1992;45:866–79.

    CAS  PubMed  Google Scholar 

  10. Kuno K, Ogawa A, Hayakawa F, Takeuchi H, Ito K, Takimoto Y, et al. Laboratory and clinical studies on meropenem in pediatrics. Jpn J Antibiot. 1992;45:880–8.

    CAS  PubMed  Google Scholar 

  11. Haruta T, Kuroki S, Okura K, Nikami H, Nishio T, Kobayashi Y. Studies on meropenem in the field of pediatrics. Jpn J Antibiot. 1992;45:897–904.

    CAS  PubMed  Google Scholar 

  12. Ikeda K, Ikawa K, Morikawa N, Miki M, Nishimura S, Kobayashi M. High-performance liquid chromatography with ultraviolet detection for real-time therapeutic drug monitoring of meropenem in plasma. J Chromatogr B Analyt Technol Biomed Life Sci. 2007;856:371–5.

    Article  CAS  PubMed  Google Scholar 

  13. Ikawa K, Morikawa N, Uehara S, Monden K, Yamada Y, Honda N, et al. Pharmacokinetic-pharmacodynamic target attainment analysis of doripenem in infected patients. Int J Antimicrob Agents. 2009;33:276–9.

    Article  CAS  PubMed  Google Scholar 

  14. Iba K, Yoshitake A. Pharmacokinetics of [14C]meropenem in dogs and monkeys. Jpn J Chemother. 1992;40(Suppl 1):145–53.

    CAS  Google Scholar 

  15. Kanazawa K, Ueda Y. In vitro antimicrobial activity of meropenem against clinical isolates of various bacterial species from pediatric patients in Japan. Jpn J Chemother. 2004;52:1–16.

    CAS  Google Scholar 

  16. Parker EM, Hutchison M, Blumer JL. The pharmacokinetics of meropenem in infants and children: a population analysis. J Antimicrob Chemother. 1995;36(Suppl A):63–71.

    CAS  PubMed  Google Scholar 

  17. Du X, Li C, Kuti JL, Nightingale CH, Nicolau DP. Population pharmacokinetics and pharmacodynamics of meropenem in pediatric patients. J Clin Pharmacol. 2006;46:69–75.

    Article  CAS  PubMed  Google Scholar 

  18. Ikawa K, Morikawa N, Ikeda K, Ohge H, Sueda T. Development of breakpoints of carbapenems for intraabdominal infections based on pharmacokinetics and pharmacodynamics in peritoneal fluid. J Infect Chemother. 2008;14:330–2.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Kazuro Ikawa.

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Ikawa, K., Morikawa, N., Ikeda, K. et al. Population pharmacokinetics and pharmacodynamics of meropenem in Japanese pediatric patients. J Infect Chemother 16, 139–143 (2010). https://doi.org/10.1007/s10156-009-0025-0

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  • DOI: https://doi.org/10.1007/s10156-009-0025-0

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