Title

Population Pharmacokinetics of Prolonged Infusion Meropenem in Cystic Fibrosis (CF) Children
An Open Label Study to Assess the Population Pharmacokinetics, Safety, and Practicality of Administering Meropenem as a Prolonged Infusion to Cystic Fibrosis Children Admitted With an Acute Pulmonary Exacerbation
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Intervention/Treatment

    meropenem ...
  • Study Participants

    30
This study will determine the concentrations of the antibiotic meropenem when administered as a 3 hour prolonged infusion in children with cystic fibrosis who are hospitalized with an acute pulmonary exacerbation. Safety and practicality of administering meropenem as a 3 hour infusion will be measured.
This study will be conducted at 7 pediatric hospitals in the United States (Columbia University Medical Center, New York, New York; University of North Carolina, Chapel Hill, North Carolina; St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, Connecticut Children's Medical Center, Hartford, Connecticut, Riley Hospital for Children, Indianapolis, Indiana, Nationwide Hospital for Children, Columbus, Ohio, and Children's Medical Center, Dallas, Texas). Cystic Fibrosis children (age 6-17 years) admitted to one of these enrolling sites with an acute exacerbation of his or her pulmonary infection who require antibiotic therapy with meropenem will be eligible. Meropenem will be administered as a 3 hour prolonged infusion and blood concentrations will be measured to determine the population pharmacokinetics in 30 patients, the safety of prolonged infusion meropenem, and the practicality as measured be treatment burden using a questionaire. The population pharmacokinetic model developed will be utilized to determine the optimal dose of meropenem to administer to children with Cystic Fibrosis, and define an exposure response relationship for the drug in this population.
Study Started
Feb 29
2012
Primary Completion
Jan 31
2014
Study Completion
Jan 31
2014
Results Posted
Mar 27
2015
Estimate
Last Update
Mar 20
2018

Drug meropenem

meropenem 40mg/kg total body weight will be administered every 8 hours. Each infusion will be infused as a 3 hour infusion.

  • Other names: Merrem

Meropenem 3 hour prolonged infusion Experimental

All 30 participants will receive meropenem as a 3 hour infusion.

Criteria

Inclusion Criteria:

Cystic Fibrosis
Hospitalized with acute pulmonary exacerbation
Caused by Pseudomonas aeruginosa or other bacteria against which meropenem would be an appropriate antibiotic treatment

Exclusion Criteria:

Known allergy to meropenem
Require less than 3 days of meropenem in the hospital
Require another systemic Beta-lactam antibiotic to treat a concomitant pathogen
Known fungal or viral infection
Females in their 2nd or 3rd trimester of pregnancy
Moderate to severe renal dysfunction, as defined by a creatinine clearance less than 50 ml/min/1.73m2 (by use of Schwartz method)
History of solid organ transplantation within previous 6 months
Active or recent (within 30 days) participation in another antibiotic clinical trial

Summary

Meropenem 3 Hour Prolonged Infusion

All Events

Event Type Organ System Event Term Meropenem 3 Hour Prolonged Infusion

Population Pharmacokinetics - Total Body Clearance

Based on meropenem concentrations, the pharmacokinetics of the study population will be analyzed to determine each patient's total body clearance.

Meropenem 3 Hour Prolonged Infusion

0.36
L/hr/kg (Mean)
Standard Deviation: 0.14

Population Pharmacokinetics - Volume of Central Compartment

Based on meropenem concentrations, the pharmacokinetics of the study population will be analyzed to determine each patient's volume of the central compartment.

Meropenem 3 Hour Prolonged Infusion

0.21
L/kg (Mean)
Standard Deviation: 0.15

Safety

This will be an intention to treat analysis of all 30 participants receiving meropenem as a 3 hour prolonged infusion. Participants will be monitored for any sign of symptom of adverse events throughout the course of the study. An adverse event will be defined as any pathologic or unintended change in the structure (signs), function (symptoms), or chemistry (laboratory values) of the body associated with the use of the study drug.

Outcome Measure Data Not Reported

Practicality of 3 Hour Prolonged Infusion

This will be an intention to treat analysis of all 30 participants receiving meropenem as a 3 hour prolonged infusion. The Cystic Fibrosis Questionnaire-Revised (CFQ-R) will be utilized to assess patient or parent assessments of the burden of the prolonged infusion treatment. The CFQ-R will be administered at the beginning of the study and then within 7 days after completion of meropenem therapy.

Outcome Measure Data Not Reported

Meropenem Pharmacodynamics

Meropenem exposures defined from the population model for each participant will be analyzed as a function of the isolated pathogens meropenem minimum inhibitory concentration (MIC) to define the exposure of meropenem associated with an absolute and relative percent change in the Forced Expiratory Volume (FEV1).

Outcome Measure Data Not Reported

Age, Continuous

12.7
years (Mean)
Standard Deviation: 2.9

Baseline Forced Expiratory Volume in 1st Second (FEV1) (% predicted)

58
% predicted (Mean)
Standard Deviation: 24

Historical Best FEV1 (% predicted)

71
% predicted (Mean)
Standard Deviation: 25

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Meropenem 3 Hour Prolonged Infusion