دورية أكاديمية

Population Pharmacokinetics and Pharmacodynamics of Ciprofloxacin Prophylaxis in Pediatric Acute Lymphoblastic Leukemia Patients

التفاصيل البيبلوغرافية
العنوان: Population Pharmacokinetics and Pharmacodynamics of Ciprofloxacin Prophylaxis in Pediatric Acute Lymphoblastic Leukemia Patients
المؤلفون: Sassen, S. D. T., Mathot, R. A. A., Pieters, R., de Haas, F.P.J.M., Kaspers, G. J. L., van den Bos, C., Tissing, W. J. E., te Loo, D. M. W. W., Bierings, M. B., van Westreenen, M., van der Sluis, I. M., Zwaan, C. M.
المصدر: Sassen , S D T , Mathot , R A A , Pieters , R , de Haas , F P J M , Kaspers , G J L , van den Bos , C , Tissing , W J E , te Loo , D M W W , Bierings , M B , van Westreenen , M , van der Sluis , I M & Zwaan , C M 2020 , ' Population Pharmacokinetics and Pharmacodynamics of Ciprofloxacin Prophylaxis in Pediatric Acute Lymphoblastic Leukemia Patients ' , Clinical Infectious Diseases , vol. 71 , no. 8 , ....
سنة النشر: 2020
المجموعة: University of Groningen research database
مصطلحات موضوعية: acute lymphoblastic leukemia, pharmacokinetics, ciprofloxacin, minimal inhibitory concentration, pediatrics, DOWN-SYNDROME, CHILDREN, RESISTANCE, ONCOLOGY, PREVENTION, SELECTION, EXPOSURE
الوصف: Background. Ciprofloxacin is used as antimicrobial prophylaxis in pediatric acute lymphoblastic leukemia (ALL) to decrease infections with gram-negative bacteria. However, there are no clear guidelines concerning prophylactic dose. Aims. To determine the pharmacokinetics and pharmacodynamics (PKPD) of ciprofloxacin prophylaxis in a pediatric ALL population. The effect of patient characteristics and antileukemic treatment on ciprofloxacin exposure, the area under the concentration time curve over minimal inhibitory concentration (AUC(24)/MIC) ratios, and emergence of resistance were studied. Methods. A total of 615 samples from 129 children (0-18 years) with ALL were collected in a multicenter prospective study. A population pharmacokinetic model was developed. Microbiological cultures were collected prior to and during prophylaxis. An AUC(24)/MIC of >= 125 was defined as target ratio. Results. A 1-compartment model with zero-order absorption and allometric scaling best described the data. No significant (P < .01) covariates remained after backward elimination and no effect of asparaginase or azoles were found. Ciprofloxacin AUC 24 was 16.9 mg*h/L in the prednisone prophase versus 29.3 mg*h/L with concomitant chemotherapy. Overall, 100%, 81%, and 18% of patients at, respectively, MIC of 0.063, 0.125, and 0.25 mg/l, achieved AUC(24)/MIC >= 125. In 13% of the patients, resistant bacteria were found during prophylactic treatment. Conclusion. Ciprofloxacin exposure shows an almost 2-fold change throughout the treatment of pediatric ALL. Depending on the appropriateness of 125 as target ratio, therapeutic drug monitoring or dose adjustments might be indicated for less susceptible bacteria starting from >= 0.125 mg/l, to prevent the emergence of resistance and reach required targets for efficacy.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
العلاقة: https://research.rug.nl/en/publications/4ca779b3-a7bf-4371-8a1c-0cd9b591b5e3Test
DOI: 10.1093/cid/ciz1163
الإتاحة: https://doi.org/10.1093/cid/ciz1163Test
https://hdl.handle.net/11370/4ca779b3-a7bf-4371-8a1c-0cd9b591b5e3Test
https://research.rug.nl/en/publications/4ca779b3-a7bf-4371-8a1c-0cd9b591b5e3Test
https://pure.rug.nl/ws/files/174099667/Hjelmfors_2020_Optimizing_of_a_question_prompt_lis.pdfTest
حقوق: info:eu-repo/semantics/openAccess
رقم الانضمام: edsbas.6548BF13
قاعدة البيانات: BASE