Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study

Autores
Butragueño Laiseca, Laura; García Orueta, Gastón; Riva, Natalia; Trocóniz, Iñaki F.; Fernández, Sarah N.; Camacho Vicente, Verónica; Padilla, Belén; Slöcker, María; Santiago, María José
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objectives: Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is ofteninaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aimsto develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, includingthose on CKRT.Methods: Data from 26 critically ill children (12 with CKRT) receiving the standard dosing regimen were analysed.In total, 172 teicoplanin concentration measurements from plasma, pre- and post-filter ports were modelled simultaneouslyusing NONMEM 7.4. Simulations were conducted to assess the target attainment (Cmin = 10 mg/L andAUC24/MIC > 800 h) of the current standard dosing regimen and of different alternative dosing regimens.Results: A two-compartment model was selected. Weight significantly affected renal clearance and volume ofdistribution of the central compartment, while filter surface area affected haemofilter clearance. Only 16 patients(59%) achieved a Cmin of >10 mg/L with the standard dosing regimen, and only 1 achieved the targetAUC/MIC. Based on simulation results, 3 × 15 mg/kg q12h + 10 mg/kg q24h (CKRT) and 3 × 15 mg/kg q12h +15 mg/kg q24h (no CKRT) could be better alternative regimens.Conclusions: This population model is a good proof of concept to develop modelling approaches that could helpin an individualized dosing approach that needs to be adopted in critically ill paediatric patients. The standardpaediatric dosage for teicoplanin could be insufficient for optimal exposure, and higher doses may benefit bothCKRT and non-CKRT patients.
Fil: Butragueño Laiseca, Laura. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: García Orueta, Gastón. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Riva, Natalia. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Trocóniz, Iñaki F.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Fernández, Sarah N.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Camacho Vicente, Verónica. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Padilla, Belén. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Slöcker, María. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Santiago, María José. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Materia
PEDIATRICS
TEICOPLANIN
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/266327
Acceder
id CONICETDig_1aecd9ca1eeafe47de3877b3392ed1a9
oai_identifier_str oai:ri.conicet.gov.ar:11336/266327
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort studyButragueño Laiseca, LauraGarcía Orueta, GastónRiva, NataliaTrocóniz, Iñaki F.Fernández, Sarah N.Camacho Vicente, VerónicaPadilla, BelénSlöcker, MaríaSantiago, María JoséPEDIATRICSTEICOPLANINhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objectives: Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is ofteninaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aimsto develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, includingthose on CKRT.Methods: Data from 26 critically ill children (12 with CKRT) receiving the standard dosing regimen were analysed.In total, 172 teicoplanin concentration measurements from plasma, pre- and post-filter ports were modelled simultaneouslyusing NONMEM 7.4. Simulations were conducted to assess the target attainment (Cmin = 10 mg/L andAUC24/MIC > 800 h) of the current standard dosing regimen and of different alternative dosing regimens.Results: A two-compartment model was selected. Weight significantly affected renal clearance and volume ofdistribution of the central compartment, while filter surface area affected haemofilter clearance. Only 16 patients(59%) achieved a Cmin of >10 mg/L with the standard dosing regimen, and only 1 achieved the targetAUC/MIC. Based on simulation results, 3 × 15 mg/kg q12h + 10 mg/kg q24h (CKRT) and 3 × 15 mg/kg q12h +15 mg/kg q24h (no CKRT) could be better alternative regimens.Conclusions: This population model is a good proof of concept to develop modelling approaches that could helpin an individualized dosing approach that needs to be adopted in critically ill paediatric patients. The standardpaediatric dosage for teicoplanin could be insufficient for optimal exposure, and higher doses may benefit bothCKRT and non-CKRT patients.Fil: Butragueño Laiseca, Laura. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: García Orueta, Gastón. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Riva, Natalia. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Trocóniz, Iñaki F.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Fernández, Sarah N.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Camacho Vicente, Verónica. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Padilla, Belén. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Slöcker, María. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaFil: Santiago, María José. Universidad de Navarra. Facultad de Farmacia y Nutricion.; EspañaOxford University Press2025-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/266327Butragueño Laiseca, Laura; García Orueta, Gastón; Riva, Natalia; Trocóniz, Iñaki F.; Fernández, Sarah N.; et al.; Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study; Oxford University Press; Journal of Antimicrobial Chemotherapy; 80; 3; 3-2025; 868-8750305-7453CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/jac/article/80/3/868/7974752info:eu-repo/semantics/altIdentifier/doi/10.1093/jac/dkaf012info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:38:32Zoai:ri.conicet.gov.ar:11336/266327instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:38:32.39CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
title Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
spellingShingle Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
Butragueño Laiseca, Laura
PEDIATRICS
TEICOPLANIN
title_short Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
title_full Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
title_fullStr Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
title_full_unstemmed Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
title_sort Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study
dc.creator.none.fl_str_mv Butragueño Laiseca, Laura
García Orueta, Gastón
Riva, Natalia
Trocóniz, Iñaki F.
Fernández, Sarah N.
Camacho Vicente, Verónica
Padilla, Belén
Slöcker, María
Santiago, María José
author Butragueño Laiseca, Laura
author_facet Butragueño Laiseca, Laura
García Orueta, Gastón
Riva, Natalia
Trocóniz, Iñaki F.
Fernández, Sarah N.
Camacho Vicente, Verónica
Padilla, Belén
Slöcker, María
Santiago, María José
author_role author
author2 García Orueta, Gastón
Riva, Natalia
Trocóniz, Iñaki F.
Fernández, Sarah N.
Camacho Vicente, Verónica
Padilla, Belén
Slöcker, María
Santiago, María José
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv PEDIATRICS
TEICOPLANIN
topic PEDIATRICS
TEICOPLANIN
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objectives: Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is ofteninaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aimsto develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, includingthose on CKRT.Methods: Data from 26 critically ill children (12 with CKRT) receiving the standard dosing regimen were analysed.In total, 172 teicoplanin concentration measurements from plasma, pre- and post-filter ports were modelled simultaneouslyusing NONMEM 7.4. Simulations were conducted to assess the target attainment (Cmin = 10 mg/L andAUC24/MIC > 800 h) of the current standard dosing regimen and of different alternative dosing regimens.Results: A two-compartment model was selected. Weight significantly affected renal clearance and volume ofdistribution of the central compartment, while filter surface area affected haemofilter clearance. Only 16 patients(59%) achieved a Cmin of >10 mg/L with the standard dosing regimen, and only 1 achieved the targetAUC/MIC. Based on simulation results, 3 × 15 mg/kg q12h + 10 mg/kg q24h (CKRT) and 3 × 15 mg/kg q12h +15 mg/kg q24h (no CKRT) could be better alternative regimens.Conclusions: This population model is a good proof of concept to develop modelling approaches that could helpin an individualized dosing approach that needs to be adopted in critically ill paediatric patients. The standardpaediatric dosage for teicoplanin could be insufficient for optimal exposure, and higher doses may benefit bothCKRT and non-CKRT patients.
Fil: Butragueño Laiseca, Laura. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: García Orueta, Gastón. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Riva, Natalia. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Trocóniz, Iñaki F.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Fernández, Sarah N.. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Camacho Vicente, Verónica. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Padilla, Belén. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Slöcker, María. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
Fil: Santiago, María José. Universidad de Navarra. Facultad de Farmacia y Nutricion.; España
description Objectives: Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is ofteninaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aimsto develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, includingthose on CKRT.Methods: Data from 26 critically ill children (12 with CKRT) receiving the standard dosing regimen were analysed.In total, 172 teicoplanin concentration measurements from plasma, pre- and post-filter ports were modelled simultaneouslyusing NONMEM 7.4. Simulations were conducted to assess the target attainment (Cmin = 10 mg/L andAUC24/MIC > 800 h) of the current standard dosing regimen and of different alternative dosing regimens.Results: A two-compartment model was selected. Weight significantly affected renal clearance and volume ofdistribution of the central compartment, while filter surface area affected haemofilter clearance. Only 16 patients(59%) achieved a Cmin of >10 mg/L with the standard dosing regimen, and only 1 achieved the targetAUC/MIC. Based on simulation results, 3 × 15 mg/kg q12h + 10 mg/kg q24h (CKRT) and 3 × 15 mg/kg q12h +15 mg/kg q24h (no CKRT) could be better alternative regimens.Conclusions: This population model is a good proof of concept to develop modelling approaches that could helpin an individualized dosing approach that needs to be adopted in critically ill paediatric patients. The standardpaediatric dosage for teicoplanin could be insufficient for optimal exposure, and higher doses may benefit bothCKRT and non-CKRT patients.
publishDate 2025
dc.date.none.fl_str_mv 2025-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/266327
Butragueño Laiseca, Laura; García Orueta, Gastón; Riva, Natalia; Trocóniz, Iñaki F.; Fernández, Sarah N.; et al.; Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study; Oxford University Press; Journal of Antimicrobial Chemotherapy; 80; 3; 3-2025; 868-875
0305-7453
CONICET Digital
CONICET
url http://hdl.handle.net/11336/266327
identifier_str_mv Butragueño Laiseca, Laura; García Orueta, Gastón; Riva, Natalia; Trocóniz, Iñaki F.; Fernández, Sarah N.; et al.; Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study; Oxford University Press; Journal of Antimicrobial Chemotherapy; 80; 3; 3-2025; 868-875
0305-7453
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/jac/article/80/3/868/7974752
info:eu-repo/semantics/altIdentifier/doi/10.1093/jac/dkaf012
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.364332

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