{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:20:45Z","timestamp":1772119245399,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007102","name":"Zagazig University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007102","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate ceftriaxone pharmacokinetics that affects the achievement of targets in the treatment of critically ill children (meningitis, pneumonia, urinary tract infection, peritonitis, and infective endocarditis( who were admitted to Zagazig University Pediatric hospital in Egypt to monitor for the drug adverse effects.<\/jats:p>\n                  <jats:p>\n                    Blood samples were obtained from 24 hospitalized pediatric patients (ages ranging from 2.5\u00a0months to 12\u00a0years) after administering the calculated dose of ceftriaxone via intravenous bolus route. Then, ceftriaxone plasma concentrations were measured using a validated HPLC method with ultraviolet detection. The pharmacokinetic analysis was conducted using Phoenix Winnonlin Program\n                    <jats:sup>\u00ae<\/jats:sup>\n                    software.\n                  <\/jats:p>\n                  <jats:p>Data for total and free ceftriaxone best fitted on a one-compartment model with the first-order elimination process. Clearance of ceftriaxone is reduced for patients with reduced kidney function and increased with those with augmented renal clearance. The volume of distribution and the free fraction are increased in these patients, especially those with hypoalbuminemia with a shorter half-life time were detected. A slight increase in total bilirubin and liver enzymes has been observed after treatment with ceftriaxone in these patients.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>\u00a0 Conclusion<\/jats:italic>\n                    :\u00a0In most critically ill pediatric patients, the current ceftriaxone treatment regimen (50 to 100\u00a0mg\/kg) offers adequate pathogenic coverage. The clearance of free ceftriaxone in all patients correlates well with their renal function (eGFR), with r2\u2009=\u20090.7252. During therapy with ceftriaxone at all doses ranging from 50 to 100\u00a0mg\/kg, a rise in total bilirubin was observed in these patients. Moreover, liver enzymes (ALT and AST) increased moderately (\n                    <jats:italic>p<\/jats:italic>\n                    0.0001). So, it is recommended to monitor total bilirubin and liver enzymes during the treatment with ceftriaxone, especially for a long duration (more than 5\u00a0days) or use another agent in patients with high baseline values.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              <jats:italic>\u2022 The dosing regimen of ceftriaxone (50 to 100\u00a0mg\/kg) provided optimum therapeutic outcomes.<\/jats:italic>\n                              <jats:italic>\u2022 Some studies show data for total and free Ceftriaxone best fitted on a one-compartment model while other studies show data for total and free Ceftriaxone best fitted on a two-compartment model.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              <jats:italic>\u2022\u00a0<\/jats:italic>\n                              <jats:italic>Up to my knowledge this is the first study ,considering individual pharmacokinetic analysis, conducted on hospitalized Egyptian pediatric population most of them with reduced kidney function with ages ranging from 2.5 months to 12 years. Data for total and free Ceftriaxone best fitted on a one-compartment model with linear clearance of the free ceftriaxone.<\/jats:italic>\n                              <jats:italic>\u2022\u00a0<\/jats:italic>\n                              <jats:italic>In all patients, total bilirubin and liver function tests were mildly increased, making them at risk for cholestasis or ceftriaxone-induced cholestatic hepatitis.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-023-05091-0","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T04:02:32Z","timestamp":1690171352000},"page":"4407-4420","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of ceftriaxone pharmacokinetics in hospitalized Egyptian pediatric patients"],"prefix":"10.1007","volume":"182","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-9623","authenticated-orcid":false,"given":"Mohamed W.","family":"Eldougdoug","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9948-5690","authenticated-orcid":false,"given":"Doaa M.","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-8841","authenticated-orcid":false,"given":"Amal S.","family":"El-Shal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0970-7136","authenticated-orcid":false,"given":"Yasmine Ahmed","family":"Sharaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-8092","authenticated-orcid":false,"given":"Sridivya","family":"Raparla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6893-1237","authenticated-orcid":false,"given":"Bhaskara R.","family":"Jasti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9148-3276","authenticated-orcid":false,"given":"Hanan M.","family":"Elnahas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"5091_CR1","unstructured":"JM, Flower RJ, Henderson G, Rang HP, Loke YK, MacEwan D (2020) Rang & Dale's pharmacology, antibacterial drugs chapter. 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The sample was taken as a comprehensive sample due to the rare attendance of cases (4 cases or less\/month), so the committee determined the sample to be 24 cases.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Parents of pediatric patients in this study signed two consent forms previously determined by the <i>IRB committee.<\/i> The first one (ZU-IRB #: FORM 2) is for initial acceptance to participate in this study. The second one (ZU-IRB #: FORM 3) is for acceptance to obtain blood samples from the patients for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}