Table 7

Characteristics of the studies, pharmacokinetics and dose recommendations of isolated studies on cefepime

StudynPNAWeightStudy designGroupModelModalityAdministered doseVdCLt1/2 (hours)Recommended dose
Thibault et al,27 USA9/170.5 (0.2–2.5) months4.4 (3.5–4.6)P
1 group
Children2-compartment with NONMEMVV–VA50 mg/kg every 6–24 hours or
100–150 mg/kg/day continuous infusion
Vdcentral+Vdperipheral=0.6 L/kg410 mL/hour/4.5 kgDosing regimens of 50 mg/kg every 8 hours reached optimal concentrations at an MIC of 8 mg/L based on simulations.
Zuppa et al,28 USA171.3–22 months3.3–10P
1 group
Infants2-compartment with NONMEMVV–VA50 mg/kg every 8–24 hoursVdcentral+Vdperipheral=0.4 L/kg
7.1 mL/min/5.8 kg
For free cefepime, only 14 of the 19 doses (74%) demonstrated an fT>MIC of 16 mg/L, an appropriate target for the treatment of pseudomonal infections, for greater than 70% of the dosing interval.
  • Boldfaced fonts represent comparisons with controls within the same study. In other studies, they represent comparisons with non-ECMO neonates from a different published study.

  • CL, clearance; ECMO, extracorporeal membrane oxygenation; MIC, minimum inhibitor concentration; NONMEM, non-linear mixed-effects modelling; P, prospective; PNA, postnatal age; t1/2, elimination half-life; VA, veno-arterial; Vd, volume of distribution; VV, veno-venous.