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Pharmacokinetics of the Meropenem Component of Meropenem-Vaborbactam in the Treatment of KPC-Producing Klebsiella pneumoniae Bloodstream Infection in a Pediatric Patient
Journal article   Peer reviewed

Pharmacokinetics of the Meropenem Component of Meropenem-Vaborbactam in the Treatment of KPC-Producing Klebsiella pneumoniae Bloodstream Infection in a Pediatric Patient

Alexandra M Hanretty, Ishminder Kaur, Alan T Evangelista, Wayne S Moore, 2nd, Adela Enache, Arun Chopra and Jeffrey J Cies
Pharmacotherapy, v 38(12), pp e87-e91
Dec 2018
DOI: https://doi.org/10.1002/phar.2187
PMID: 30300440
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - pharmacokinetics Boronic Acids - administration & dosage Boronic Acids - pharmacokinetics Child, Preschool Drug Therapy, Combination Humans Klebsiella Infections - blood Klebsiella Infections - diagnosis Klebsiella Infections - drug therapy Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - isolation & purification Male Meropenem - administration & dosage Meropenem - pharmacokinetics Treatment Outcome
Meropenem-vaborbactam is a new β-lactam/β-lactamase inhibitor combination designed to target Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Meropenem-vaborbactam was United States Food and Drug Administration-approved for complicated urinary tract infections in patients 18 years of age or older. An understanding of the pharmacokinetics of meropenem when given in combination with vaborbactam is important to understanding the dosing of meropenem-vaborbactam. In addition, the safety and efficacy of meropenem-vaborbactam in a pediatric patient have yet to be described in the literature. The authors conducted a retrospective single-patient chart review for a 4-year-old male patient with short bowel syndrome, colostomy and gastrojejunal tube, bronchopulmonary dysplasia, and a central line for chronic total parenteral nutrition and hydration management, complicated with multiple central line-associated bloodstream infections (BSIs). The patient was brought to our medical center with fever concerning for a BSI. On day 2, the patient was started on meropenem-vaborbactam at a dosage of 40 mg/kg every 6 hours infused over 3 hours for KPC-producing K. pneumoniae BSI. Meropenem serum concentrations obtained on day 5 of meropenem-vaborbactam therapy, immediately following the completion of the infusion and 1 hour after the infusion, were 51.3 and 13.6 μg/ml, respectively. Serum concentrations correlated to a volume of distribution of 0.59 L/kg and a clearance of 13.1 ml/min/kg. Repeat blood cultures remained negative, and meropenem-vaborbactam was continued for a total of 14 days. A meropenem-vaborbactam regimen of 40 mg/kg every 6 hours given over 3 hours was successful in providing a target attainment of 100% for meropenem serum concentrations above the minimum inhibitory concentration for at least 40% of the dosing interval and was associated with successful bacteremia clearance in a pediatric patient.

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Collaboration types
Domestic collaboration
Web of Science research areas
Pharmacology & Pharmacy
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