Developing tailored dosing recommendations for ciprofloxacin in critically ill children using a population approach based on total and unbound concentrations.

Summary

A prospective multicentre population pharmacokinetic study of intravenous ciprofloxacin in 44 critically ill children under 16 years, measuring total and unbound plasma concentrations plus urinary excretion. A two-compartment allometric model identified glomerular filtration rate and mechanical ventilation as covariates of clearance, and target attainment was simulated across doses. The authors report that standard regimens may underexpose nonventilated children with normal or augmented renal function, and propose tailored dosing for further prospective evaluation. Useful background for PICU clinicians considering antimicrobial dose individualisation, though it is a single PK study rather than a formal guideline.

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