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We aimed to develop pharmacokinetic\u2013pharmacodynamic (PKPD) model of meropenem and CRP in neonates\/infants and evaluate its predictive performance of CRP dynamics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from neonates\/infants treated with meropenem in 3 previous studies were analysed. To the previously developed meropenem PK models, the addition of turnover, transit or effect compartment, delay differential equation PD models of CRP as a function of meropenem concentration or its cumulative area under the curve (AUC) were evaluated. The percentage of neonates\/infants (P<jats:sub>0.1<\/jats:sub>, P<jats:sub>0.2<\/jats:sub>) in whom the ratio of the fifth day CRP to its peak value was predicted with an error of &lt;0.1 (&lt;0.2) was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 60 meropenem treatment episodes (median [range] gestational age 27.6 [22.6\u201340.9] weeks, postnatal age 13 [2\u201389] days) with a total of 351 CRP concentrations (maximum value 65.5 [13\u2013358.4] mg\/L) were included. Turnover model of CRP as a function of meropenem cumulative AUC provided the best fit and included CRP at the start of treatment, use of prior antibiotics, study and causative agent <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content> or enterococci as covariates. Using meropenem population predictions and data available at 0, 24, 48, 72\u2009h after the start of treatment, P<jats:sub>0.1<\/jats:sub> (P<jats:sub>0.2<\/jats:sub>) was 36.4, 36.4, 60.6 and 66.7% (70.0, 66.7, 72.7 and 78.7%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The developed PKPD model of meropenem and CRP as a function of meropenem cumulative AUC incorporating several patient characteristics predicts CRP dynamics with an error of &lt;0.2 in most neonates\/infants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15950","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T01:53:25Z","timestamp":1698717205000},"page":"801-811","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of C\u2010reactive protein dynamics during meropenem treatment in neonates and infants"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6475-7801","authenticated-orcid":false,"given":"Hiie","family":"Soeorg","sequence":"first","affiliation":[{"name":"Department of Microbiology University of Tartu  Tartu Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helgi","family":"Padari","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Tartu University Hospital  Tartu Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari\u2010Liis","family":"Ilmoja","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Tallinn Children's Hospital  Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koit","family":"Herodes","sequence":"additional","affiliation":[{"name":"Institute of Chemistry University of Tartu  Tartu 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