Use of Antibiotics in Preterm Newborns

• Published in: Antibiotics (Basel) Vol. 11; no. 9; p. 1142
• Main Authors: Simeoli, Raffaele, Cairoli, Sara, Decembrino, Nunzia, Campi, Francesca, Dionisi Vici, Carlo, Corona, Alberto, Goffredo, Bianca Maria
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 23.08.2022; MDPI
• Subjects: Age; Analysis; Antibiotics; Antiinfectives and antibacterials; Blood; Drug dosages; Drug therapy; Health aspects; Hospitals; Infants (Newborn); Intensive care units; Medical examination; Medical research; Medical screening; Medicine, Experimental; micro-sampling; Neonatal intensive care; Neonates; Nosocomial infections; Nutrition; Parenting; Pediatrics; pharmacodynamic; pharmacokinetic; Pharmacokinetics; Pharmacology; Physiological aspects; Physiology; Population; Pregnancy; Premature birth; preterms; Review; Sampling techniques; therapeutic drug monitoring; Therapeutic targets; Ventilators; United Kingdom
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11091142

Due to complex maturational and physiological changes that characterize neonates and affect their response to pharmacological treatments, neonatal pharmacology is different from children and adults and deserves particular attention. Although preterms are usually considered part of the neonatal population, they have physiological and pharmacological hallmarks different from full-terms and, therefore, need specific considerations. Antibiotics are widely used among preterms. In fact, during their stay in neonatal intensive care units (NICUs), invasive procedures, including central catheters for parental nutrition and ventilators for respiratory support, are often sources of microbes and require antimicrobial treatments. Unfortunately, the majority of drugs administered to neonates are off-label due to the lack of clinical studies conducted on this special population. In fact, physiological and ethical concerns represent a huge limit in performing pharmacokinetic (PK) studies on these subjects, since they limit the number and volume of blood sampling. Therapeutic drug monitoring (TDM) is a useful tool that allows dose adjustments aiming to fit plasma concentrations within the therapeutic range and to reach specific drug target attainment. In this review of the last ten years’ literature, we performed Pubmed research aiming to summarize the PK aspects for the most used antibiotics in preterms.