Phase I Study Assessing the Pharmacokinetic Profile, Safety, and Tolerability of a Single Dose of Ceftazidime-Avibactam in Hospitalized Pediatric Patients

John S Bradley, Jon Armstrong, Antonio Arrieta, Raafat Bishai, Shampa Das, Shirley Delair, Timi Edeki, William C Holmes, Jianguo Li, Kathryn S Moffett, Deepa Mukundan, Norma Perez, José R Romero, David Speicher, Janice E Sullivan, Diansong Zhou, John S Bradley, Jon Armstrong, Antonio Arrieta, Raafat Bishai, Shampa Das, Shirley Delair, Timi Edeki, William C Holmes, Jianguo Li, Kathryn S Moffett, Deepa Mukundan, Norma Perez, José R Romero, David Speicher, Janice E Sullivan, Diansong Zhou

Abstract

This study aimed to investigate the pharmacokinetics (PK), safety, and tolerability of a single dose of ceftazidime-avibactam in pediatric patients. A phase I, multicenter, open-label PK study was conducted in pediatric patients hospitalized with an infection and receiving systemic antibiotic therapy. Patients were enrolled into four age cohorts (cohort 1, ≥12 to <18 years; cohort 2, ≥6 to <12 years; cohort 3, ≥2 to <6 years; cohort 4, ≥3 months to <2 years). Patients received a single 2-h intravenous infusion of ceftazidime-avibactam (cohort 1, 2,000 to 500 mg; cohort 2, 2,000 to 500 mg [≥40 kg] or 50 to 12.5 mg/kg [<40 kg]; cohorts 3 and 4, 50 to 12.5 mg/kg). Blood samples were collected to describe individual PK characteristics for ceftazidime and avibactam. Population PK modeling was used to describe characteristics of ceftazidime and avibactam PK across all age groups. Safety and tolerability were assessed. Thirty-two patients received study drug. Mean plasma concentration-time curves, geometric mean maximum concentration (Cmax), and area under the concentration-time curve from time zero to infinity (AUC0-∞) were similar across all cohorts for both drugs. Six patients (18.8%) reported an adverse event, all mild or moderate in intensity. No deaths or serious adverse events occurred. The single-dose PK of ceftazidime and avibactam were comparable between each of the 4 age cohorts investigated and were broadly similar to those previously observed in adults. No new safety concerns were identified. (This study has been registered at ClinicalTrials.gov under registration no. NCT01893346.).

Copyright © 2016 Bradley et al.

Figures

FIG 1
FIG 1
Arithmetic mean (±SD) plasma concentration-time curves for ceftazidime for cohorts 1 to 4 following single-dose (day 1) administration of ceftazidime-avibactam (pharmacokinetic analysis population).
FIG 2
FIG 2
Arithmetic mean (±SD) plasma concentration-time curves for avibactam for cohorts 1 to 4 following single-dose (day 1) administration of ceftazidime-avibactam (pharmacokinetic analysis population).

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