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Systematic Review of Linezolid Population Pharmacokinetics in Pediatric: Models, Covariates, and Dosing Implication Primasari, Firdhani Satia; Hakim, Arief Rahman
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 15, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.108892

Abstract

Background: The increasing prevalence of bacterial resistance has positioned linezolid as a promising antibiotic for treating infections, including in pediatric patients. Knowledge of pharmacokinetic parameters is very useful in optimizing the dose to be used in patient therapy. However, pharmacokinetic data to guide optimized dosing in children remain limited.Objectives: This review aims to summarize population pharmacokinetic (PopPK) models of linezolid in pediatric populations and identify significant covariates influencing its pharmacokinetics.Methods: A systematic search was conducted in PubMed and ScienceDirect databases for studies published between 2014 and May 2025 using the keywords "linezolid", "population pharmacokinetics", and "pharmacokinetic model".Results: Six studies met the inclusion criteria and were analysed. The pharmacokinetic models were mainly based on blood concentration measurements and constructed using NONMEM in four studies. Most studies employed one-compartment models. Clearance values ranged from 0.068 to 5.82 L/h, and volume of distribution from 0.783 to 10.5 L. Body weight consistently emerged as a significant predictor of clearance, while body surface area was associated with volume of distribution.Conclusion: PopPK modeling highlights considerable variability in linezolid pharmacokinetics among pediatric patients, influenced primarily by weight and other covariates. Further studies are needed to compare oral versus IV formulations and to incorporate unbound (free) drug concentrations for improved dose optimization in pediatric populations.
Evaluasi Penggunaan Antibiotik Definitif pada Pasien dengan Infeksi Bakteri Resisten Carbapenem di RSUP Dr. Sardjito, Yogyakarta Primasari, Firdhani Satia; Sari, Ika Puspita; Nuryastuti, Titik
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 22 No. 02 Desember 2025
Publisher : Pharmacy Faculty, Universitas Muhammadiyah Purwokerto

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Abstract

Currently, many countries have reported infections caused by carbapenem-resistant bacteria, and Indonesia is no exception. This condition makes the scope of therapeutic options becomes quite limited. This study aims to evaluate the definitive antibiotics used in patients with carbapenem-resistant bacterial infections along with the calculation of the predictive value of pharmacokinetic parameters which are then linked to the patient's clinical outcome. This research is a retrospective descriptive-analytic study. The subjects of this study were all inpatients with carbapenem-resistant bacterial infections in the period January-March 2020. Antibiotic suitability evaluation was analyzed descriptively, the estimated values ​​of pharmacokinetic parameters were calculated using the pharmacokinetic calculation formula, and the correlation between the estimated pharmacokinetic values ​​and clinical outcomes of the patients was analyzed statistically using Fisher test. The results of the evaluation of definitive antibiotic administration in patients with carbapenem-resistant bacterial infections found that 11 antibiotics met the suitability of the type, dose, frequency, and duration of the 27 antibiotics analyzed. The predicted value of the pharmacokinetic parameters of the 11 definitive antibiotics in the form of minimal levels in the blood at steady state compared to the MIC value showed that 1 (9.1%) antibiotic had a Cssmin value ≥ MIC and 10 (90.9%) other antibiotics had a Cssmin value < MIC. There is no relationship between the predictive value of the pharmacokinetic parameters of definitive antibiotics that meet regimen suitability and clinical outcomes in patients with carbapenem-resistant bacterial infections. In general, although the dosage regimen of definitive antibiotics meet the suitability criteria, drug concentration in blood can be inadequate to eradicate the bacteria due to many factors and can influence the clinical outcomes.