{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:10:53Z","timestamp":1785409853829,"version":"3.56.0"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Medical Scientific and Technological Project in Henan Province","award":["LHGJ20230587"],"award-info":[{"award-number":["LHGJ20230587"]}]},{"name":"Zhengzhou Medical Research Project","award":["ZZYK2024088"],"award-info":[{"award-number":["ZZYK2024088"]}]},{"name":"Scientific and Technological Project in Henan Province","award":["262102311034"],"award-info":[{"award-number":["262102311034"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Levofloxacin is recommended as an optional treatment for pediatric patients with severe refractory\n                      <jats:italic toggle=\"yes\">Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (SRMPP), but its use remains off-label due to limited pharmacokinetic\/pharmacodynamic (PK\/PD) data in this population. This study aimed to characterize the PK\/PD properties of levofloxacin in pediatric SRMPP patients and define optimal dosing regimens. Scavenged blood samples from patients aged \u226418 years were collected using opportunistic sampling strategy to develop a population pharmacokinetic (PopPK) model of levofloxacin. The Cox proportional hazards model was applied to identify the optimal AUC\n                      <jats:sub>ss,0\u201324h<\/jats:sub>\n                      cutoff associated with improved efficacy (shorter levofloxacin treatment duration and shorter cough resolution). Monte Carlo simulations were then performed to evaluate target attainment for this efficacy cutoff under guideline regimens (8\u201310 mg\/kg q12 h for ages 1\u20135 years; 8\u201310 mg\/kg q24 h for ages 5\u201316 years). A total of 191 pediatric patients (0.16\u201316 years) with SRMPP receiving intravenous levofloxacin were included in the PK analysis, and 161 patients were included in the exposure-response analysis. A two-compartment PopPK model was developed, identifying body weight as a significant covariate on clearance and central volume of distribution, and serum creatinine as an additional covariate on clearance. Patients with AUC\n                      <jats:sub>ss,0\u201324h<\/jats:sub>\n                      \u2265 30.74 mg\u00b7h\/L achieved shorter levofloxacin treatment duration (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.019). Guideline-recommended dosing regimens result in overexposure in children &lt;5 years and underexposure in those \u22655 years. Our model-based analysis suggests that 11 mg\/kg q24 h or 5.5 mg\/kg q12 h may provide more appropriate dosing regimens for children aged 1\u201316 years for the treatment of SRMPP.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01853-25","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:00:21Z","timestamp":1776679221000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Population pharmacokinetics and exposure-response analysis of levofloxacin in Chinese pediatric patients with severe refractory\n                    <i>Mycoplasma pneumoniae<\/i>\n                    pneumonia"],"prefix":"10.1128","volume":"70","author":[{"given":"Xingru","family":"Tao","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04ypx8c21","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy, Children's Hospital 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