Evaluation of ceftriaxone pharmacokinetics in hospitalized Egyptian pediatric patients

Critically ill pediatric patients often require ceftriaxone for serious infections, but pharmacokinetic data to guide dosing and monitor for adverse effects in this population, particularly outside high-resource settings, are limited. This study measured total and free ceftriaxone plasma concentrations in 24 hospitalized Egyptian pediatric patients (ages 2.5 months to 12 years) following intravenous dosing, with pharmacokinetic analysis performed using Phoenix WinNonlin. A one-compartment model best described ceftriaxone disposition, with clearance closely correlated to renal function and increased volume of distribution and shorter half-life observed in patients with hypoalbuminemia; mild increases in bilirubin and liver enzymes were also observed during treatment. The findings support the current 50-100 mg/kg ceftriaxone dosing regimen for most critically ill children while recommending monitoring of bilirubin and liver enzymes during longer courses of therapy.