| Title: |
Prolonged Post-Discontinuation Antibiotic Exposure in Very Low Birth Weight Neonates at Risk for Early-Onset Sepsis |
| Authors: |
Le, Jennifer; Greenberg, Rachel G; Benjamin, Daniel K; Yoo, YoungJun; Zimmerman, Kanecia O; Cohen-Wolkowiez, Michael; Wade, Kelly C; Hornik, Christoph; Zimmerman, Kanecia; Kennel, Phyllis; Beci, Rose; Hornik, Chi Dang; Kearns, Gregory L; Laughon, Matthew; Paul, Ian M; Sullivan, Janice; Wade, Kelly; Delmore, Paula; Taylor-Zapata, Perdita; Lee, June; Anand, Ravinder; Sharma, Gaurav; Simone, Gina; Kaneshige, Kim; Taylor, Lawrence; Green, Thomas |
| Source: |
Journal of the Pediatric Infectious Diseases Society, vol 10, iss 5 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2021 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
3213 Paediatrics (for-2020); 32 Biomedical and Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Hematology (rcdc); Infectious Diseases (rcdc); Sepsis (rcdc); Preterm; Low Birth Weight and Health of the Newborn (rcdc); Pediatric (rcdc); Perinatal Period - Conditions Originating in Perinatal Period (rcdc); Emerging Infectious Diseases (rcdc); Infection (hrcs-hc); 3 Good Health and Well Being (sdg); Anti-Bacterial Agents (mesh); Escherichia coli (mesh); Humans (mesh); Infant (mesh); Infant; Newborn (mesh); Very Low Birth Weight (mesh); Retrospective Studies (mesh); Sepsis (mesh); ampicillin; antimicrobial stewardship; early-onset sepsis; gentamicin; Monte Carlo simulation; neonatal sepsis; neonate; pharmacokinetics |
| Subject Geographic: |
615 - 621 |
| Description: |
BACKGROUND: Premature, very low birth weight (VLBW) neonates are at risk for early-onset sepsis and receive ampicillin and gentamicin post-birth. Antimicrobial stewardship supports short-course antibiotics, but how long antibiotic concentrations remain therapeutic post-last dose is unknown. METHODS: Using Monte Carlo simulations (NONMEM 7.3), we analyzed antibiotic exposures in a retrospective cohort of 34 689 neonates ( MIC range. After the last dose, the PDAE mean (95% confidence interval [CI]) ranged from 34 to 50 hours (17-79) for E. coli (MIC 8) and 82 to 104 hours (95% CI: 39-122) for GBS (MIC 0.25); longer PDAE occurred with higher dose, shorter interval, and longer course. Short-course ampicillin (2 doses, 50 mg/kg every 12 hours) provided PDAE 34 hours for E. coli and 82 hours for GBS. Single-dose 5 mg/kg gentamicin provided PDAE > MIC 2 for 26 hours. CONCLUSIONS: In VLBW neonates, ampicillin exposure remains therapeutic long after the last dose. Short-course ampicillin provided therapeutic exposures throughout the typical blood culture incubation period. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt6mz6f9vj; https://escholarship.org/uc/item/6mz6f9vj; https://escholarship.org/content/qt6mz6f9vj/qt6mz6f9vj.pdf |
| DOI: |
10.1093/jpids/piaa172 |
| Availability: |
https://escholarship.org/uc/item/6mz6f9vj; https://escholarship.org/content/qt6mz6f9vj/qt6mz6f9vj.pdf; https://doi.org/10.1093/jpids/piaa172 |
| Rights: |
public |
| Accession Number: |
edsbas.EE18524B |
| Database: |
BASE |