{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:05:51Z","timestamp":1788566751319,"version":"build-2803163510"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["109-S4618"],"award-info":[{"award-number":["109-S4618"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Drug Safety"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with low body weight (LBW) often exhibit altered pharmacokinetics (PK) in renal clearance and total body water. These changes complicate \u03b2-lactam antibiotic dosing, potentially resulting in suboptimal efficacy or increased toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the attainment of PK\/pharmacodynamic (PD) targets, the prevalence of subtherapeutic and supratherapeutic concentrations, and the incidence of neurotoxicity among LBW patients treated with piperacillin\/tazobactam (TZP), cefepime (FEP), and meropenem (MEM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A prospective observational study conducted at a tertiary hospital from January 2020 to December 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Adult patients with a body mass index \u2a7d18.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      who received TZP, FEP, or MEM were included. Trough serum concentrations were analyzed for PK\/PD targets: 100% time above minimum inhibitory concentration (100% fT\u2009&gt;\u2009MIC) and 100% time above four times MIC (100% fT\u2009&gt;\u20094MIC). Neurotoxicity was assessed using standardized criteria. Statistical analyses identified factors associated with concentration variability and adverse outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventy-two patients were included: 29 received TZP, 23 FEP, and 20 MEM. Achievement of the 100% fT\u2009&gt;\u2009MIC target was comparable across all antibiotics (~70%), but 100% fT\u2009&gt;\u20094 MIC attainment was significantly higher for FEP (47.8%) than for TZP (10.3%) and MEM (30%) ( p\u2009=\u20090.01). Supratherapeutic concentrations were observed in 34.8% of FEP users compared to 3.4% and 5% for TZP and MEM, respectively ( p\u2009=\u20090.002). Neurotoxicity occurred in 13% of FEP patients but was not reported in TZP or MEM groups ( p\u2009=\u20090.04). Subtherapeutic concentrations were noted in approximately 30% of patients across all groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PK changes complicate \u03b2-lactam antibiotic dosing, resulting in frequent failure to achieve PK\/PD targets. FEP demonstrated a particularly high risk of supratherapeutic concentrations and neurotoxicity. Therapeutic drug monitoring is crucial to optimize dosing and improve safety in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20420986251320414","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T07:13:51Z","timestamp":1739949231000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Navigating pharmacokinetic and pharmacodynamics challenges of \u03b2-lactam antibiotics in patients with low body weight: efficacy, toxicity, and dosage optimization"],"prefix":"10.1177","volume":"16","author":[{"given":"Yu-Ju","family":"Tseng","sequence":"first","affiliation":[{"name":"Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan"},{"name":"School of Pharmacy, College of Medicine, National Taiwan University, Taipei, 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