PharmPK Discussion - Meropenem drug monitoring in 3.5 mo infant

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On 10 Sep 2003 at 15:33:26, "Kazimierz H. Kozlowski" (khkoz.-at-.czd.waw.pl) sent the message


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Dear PharmPK list users,
Patient 5kg, 3.5 month age after heart advanced reconstruction (Down
syndrome),
3.5 week on Intensive Care Unit. She is infected  with
fluconazole-sensitive Candida
and non-diagnosed sepsis and pulmonary infection (vancomycin +
meropenem).
According to current developed HPLC assay of Meropenem following
arterial level
after 20 mg/kg in 30 min infusions every 8 h are obtained (after 4th
dose):
10.1 mcg/ml- 3 h after end of infusion; 1.2 mcg/ml - 6 h after end of
infusion.

I need to know is it correct dose with this antibiotic for such infant
(extensive
Furosemid).
Time-dependent or concentration-dependent antibiotic?
sincerely
Kazimierz H. Kozlowski
Laboratory of Pharmacokinetics
The Childrens Memorial Health Institute
04-736 Warsaw, Poland

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On 12 Oct 2003 at 01:21:23, GLDrusano.at.aol.com sent the message


The following message was posted to: PharmPK

HI!

This is a Time > MIC drug. This carbapenem maximizes kill with 40% of
the dosing interval covered by free (non-protein bound) drug. The
binding to proteins is VERY low. Given the 10 mg/L measured
concentration, the regimen would be expected to be quite robust up to
an MIC of around 8 mg/L.

Hope this helps.

George Drusano

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