title: Dose optimisation of antibiotics in children: application of pharmacokinetics/pharmacodynamics in paediatrics.
abstract: The judicious use of antibiotics to combat infections in children relies upon appropriate selection of an agent, dose and duration to maximise efficacy and to minimise toxicity. Critical to dose optimisation is an understanding of the pharmacokinetics and pharmacodynamics of available drugs. Optimal dosing strategies may take advantage of pharmacokinetic/pharmacodynamic (PK/PD) principles so that antibiotic dosing can be individualised to assure effective bacterial killing in patients who have altered pharmacokinetics or who have infections with less susceptible or resistant organisms. This review will outline the fundamentals of antimicrobial pharmacokinetics/pharmacodynamics through discussion of antibacterial agents most often used in children. We aim to highlight the importance of dose optimisation in paediatrics and describe non-conventional dosing strategies that can take advantage of PK/PD principles at the bedside.
authors.affiliation: Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Downes
authors.affiliation: Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Hahn
authors.affiliation: Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Wiles
authors.affiliation: Department of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Courter
authors.affiliation: Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: sander.vinks@cchmc.org.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Vinks
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000494:pharmacology; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Dose optimisation; PK/PD; Pharmacodynamics; Pharmacokinetics