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. 2022 Sep 21:13:964005.
doi: 10.3389/fphar.2022.964005. eCollection 2022.

Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review

Abdul Haseeb  1 , Hani Saleh Faidah  2 , Saleh Alghamdi  3 , Amal F Alotaibi  1 , Mahmoud Essam Elrggal  1 , Ahmad J Mahrous  1 , Safa S Almarzoky Abuhussain  1 , Najla A Obaid  4 , Manal Algethamy  5 , Abdullmoin AlQarni  6 , Asim A Khogeer  7   8 , Zikria Saleem  9 , Muhammad Shahid Iqbal  10 , Sami S Ashgar  2 , Rozan Mohammad Radwan  11 , Alaa Mutlaq  12 , Nayyra Fatani  13 , Aziz Sheikh  14
Affiliations

Dose optimization of β-lactams antibiotics in pediatrics and adults: A systematic review

Abdul Haseeb et al. Front Pharmacol. .

Abstract

Background: β-lactams remain the cornerstone of the empirical therapy to treat various bacterial infections. This systematic review aimed to analyze the data describing the dosing regimen of β-lactams. Methods: Systematic scientific and grey literature was performed in accordance with Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The studies were retrieved and screened on the basis of pre-defined exclusion and inclusion criteria. The cohort studies, randomized controlled trials (RCT) and case reports that reported the dosing schedule of β-lactams are included in this study. Results: A total of 52 studies met the inclusion criteria, of which 40 were cohort studies, 2 were case reports and 10 were RCTs. The majority of the studies (34/52) studied the pharmacokinetic (PK) parameters of a drug. A total of 20 studies proposed dosing schedule in pediatrics while 32 studies proposed dosing regimen among adults. Piperacillin (12/52) and Meropenem (11/52) were the most commonly used β-lactams used in hospitalized patients. As per available evidence, continuous infusion is considered as the most appropriate mode of administration to optimize the safety and efficacy of the treatment and improve the clinical outcomes. Conclusion: Appropriate antibiotic therapy is challenging due to pathophysiological changes among different age groups. The optimization of pharmacokinetic/pharmacodynamic parameters is useful to support alternative dosing regimens such as an increase in dosing interval, continuous infusion, and increased bolus doses.

Keywords: beta-Lactams; carbapenems; cephalosporins; dose optimization; penicillins.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
See this image and copyright information in PMC

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