{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T17:40:11Z","timestamp":1748972411179,"version":"3.41.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","funder":[{"DOI":"10.13039\/100014452","name":"College of Medicine, University of Cincinnati","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100014452","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute of Child Health and Human Development","award":["5T32HD069054"],"award-info":[{"award-number":["5T32HD069054"]}]},{"DOI":"10.13039\/100007172","name":"Cincinnati Children's Hospital Medical Center","doi-asserted-by":"crossref","award":["Arnold W. Strauss Fellow Award; Pediatric Hospital Medicine Fellow Award"],"award-info":[{"award-number":["Arnold W. Strauss Fellow Award; Pediatric Hospital Medicine Fellow Award"]}],"id":[{"id":"10.13039\/100007172","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["K01MD017289"],"award-info":[{"award-number":["K01MD017289"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"crossref","award":["R35GM146701"],"award-info":[{"award-number":["R35GM146701"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Critically ill patients with cardiac or respiratory failure may require extracorporeal membrane oxygenation (ECMO). Antibiotics are frequently administered when the suspected cause of organ failure is an infection. Ceftriaxone, a \u03b2-lactam antibiotic, is commonly used in patients who are critically ill. Although studies in adults on ECMO have suggested minimal impact on ceftriaxone pharmacokinetics, limited research exists on ceftriaxone pharmacokinetics\/pharmacodynamics (PK\/PD) in pediatric ECMO patients. We report the PK profiles and target attainment of 2 pediatric patients on ECMO who received ceftriaxone.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Ceftriaxone concentrations were measured in 2 pediatric patients on ECMO using scavenged opportunistic sampling. PK profiles were generated and individual PK parameters were estimated using measured free ceftriaxone concentrations and a published population PK model in children who are critically ill, using Bayesian estimation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Patient 1, an 11-year-old boy on venovenous ECMO for respiratory failure received 2 doses of 52 mg\/kg ceftriaxone 12 hours apart while on ECMO and additional doses every 12 hours off ECMO. On ECMO, ceftriaxone clearance was 13.0 L\/h\/70 kg compared with 7.6 L\/h\/70 kg off ECMO, whereas the model-predicted mean clearance in children who are critically ill without ECMO support was 6.54 L\/h\/70 kg. Patient 2, a 2-year-old boy on venoarterial ECMO due to cardiac arrest received 50 mg\/kg ceftriaxone every 12 hours while on ECMO for &gt;7 days. Only clearance while on ECMO could be estimated (9.1 L\/h\/70 kg). Trough concentrations in both patients were &gt;1 mg\/L (the breakpoint for <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>) while on ECMO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>ECMO increased ceftriaxone clearance above the model-predicted clearances in the 2 pediatric patients studied. Twelve-hour dosing allowed concentrations to remain above the breakpoint for commonly targeted bacteria but not 4 times the breakpoint in one patient, suggesting that precision dosing may be beneficial to ensure target attainment in children on ECMO.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ftd.0000000000001133","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T18:04:55Z","timestamp":1695146695000},"page":"832-836","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ceftriaxone Pharmacokinetics and Pharmacodynamics in 2 Pediatric Patients on Extracorporeal Membrane Oxygenation Therapy"],"prefix":"10.1097","volume":"45","author":[{"given":"Francisco C.","family":"Cervantes","sequence":"first","affiliation":[{"name":"Department of Medical Education, University of Cincinnati College of Medicine, Cincinnati, Ohio. Arbough is now with the Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Clinical Pharmacology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Clinical Pharmacology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Pathology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trent","family":"Arbough","sequence":"additional","affiliation":[{"name":"Department of Medical Education, University of Cincinnati College of Medicine, Cincinnati, Ohio. Arbough is now with the Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A.","family":"Vinks","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Clinical Pharmacology,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer M.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Critical Care Medicine, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonya C.","family":"Tang Girdwood","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"},{"name":"Clinical Pharmacology,"},{"name":"Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"R1-20250603","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-018-2155-1","article-title":"Pharmacokinetics-pharmacodynamics issues relevant for the clinical use of beta-lactam antibiotics in critically ill patients","volume":"22","author":"Veiga","year":"2018","journal-title":"Crit Care"},{"key":"R2-20250603","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11908-018-0613-1","article-title":"Pharmacokinetic\/pharmacodynamic considerations of beta-lactam antibiotics in adult critically ill patients","volume":"20","author":"Masich","year":"2018","journal-title":"Curr Infect Dis Rep."},{"key":"R3-20250603","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.ijantimicag.2012.02.010","article-title":"What's behind the failure of emerging antibiotics in the critically ill?: understanding the impact of altered pharmacokinetics and augmented renal clearance","volume":"39","author":"Udy","year":"2012","journal-title":"Int J Antimicrob Agents"},{"key":"R4-20250603","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1097\/CCM.0b013e3181961bff","article-title":"Pharmacokinetic issues for antibiotics in the critically ill patient","volume":"37","author":"Roberts","year":"2009","journal-title":"Crit Care Med."},{"key":"R5-20250603","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-017-1871-2","article-title":"Identifying \u201cat-risk\u201d patients for sub-optimal beta-lactam exposure in critically ill patients with severe infections","volume":"21","author":"Abdul-Aziz","year":"2017","journal-title":"Crit Care"},{"key":"R6-20250603","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-03272-z","article-title":"Failure of target attainment of beta-lactam antibiotics in critically ill patients and associated risk factors: a two-center prospective study (EXPAT)","volume":"24","author":"Abdulla","year":"2020","journal-title":"Crit Care"},{"key":"R7-20250603","doi-asserted-by":"crossref","first-page":"106326","DOI":"10.1016\/j.ijantimicag.2021.106326","article-title":"Letter to the editor regarding: ceftriaxone exposure in patients undergoing extracorporeal membrane oxygenation","volume":"57","author":"Gijsen","year":"2021","journal-title":"Int J Antimicrob Agents"},{"key":"R8-20250603","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s40262-021-01106-x","article-title":"Population pharmacokinetics and dosing simulations of ceftriaxone in critically ill patients receiving extracorporeal membrane oxygenation (An ASAP ECMO Study)","volume":"61","author":"Cheng","year":"2022","journal-title":"Clin Pharmacokinet."},{"key":"R9-20250603","doi-asserted-by":"crossref","first-page":"35","DOI":"10.12788\/jhm.3380","article-title":"Methodologic progress note: opportunistic sampling for pharmacology studies in hospitalized children","volume":"16","author":"Girdwood","year":"2020","journal-title":"J Hosp Med."},{"key":"R10-20250603","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1002\/jcph.1773","article-title":"Demonstrating feasibility of an opportunistic sampling approach for pharmacokinetic studies of beta-lactam antibiotics in critically ill children","volume":"61","author":"Tang Girdwood","year":"2021","journal-title":"J Clin Pharmacol."},{"key":"R11-20250603","doi-asserted-by":"crossref","first-page":"e1521","DOI":"10.1128\/AAC.01427-21","article-title":"Population pharmacokinetic modeling of total and free ceftriaxone in critically ill children and young adults and Monte Carlo simulations support twice daily dosing for target attainment","volume":"66","author":"Tang Girdwood","year":"2022","journal-title":"Antimicrob Agents Chemother."},{"key":"R12-20250603","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/0010-4825(92)90011-B","article-title":"MW\/Pharm, an integrated software package for drug dosage regimen calculation and therapeutic drug monitoring","volume":"22","author":"Proost","year":"1992","journal-title":"Comput Biol Med."},{"key":"R13-20250603","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.cmi.2015.05.002","article-title":"Optimization of dosing regimens and dosing in special populations","volume":"21","author":"Sime","year":"2015","journal-title":"Clin Microbiol Infect."},{"key":"R14-20250603","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s40262-012-0020-y","article-title":"Benchmarking therapeutic drug monitoring software: a review of available computer tools","volume":"52","author":"Fuchs","year":"2013","journal-title":"Clin Pharmacokinet."},{"key":"R15-20250603","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1146\/annurev.pharmtox.48.113006.094708","article-title":"Mechanism-based concepts of size and maturity in pharmacokinetics","volume":"48","author":"Anderson","year":"2008","journal-title":"Annu Rev Pharmacol Toxicol."}],"container-title":["Therapeutic Drug 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