Table 9.14Evidence profile for intravenous benzylpenicillin (50,000 IU/kg) every 12 hours in preterm babies (< 32 weeks’ gestation) with suspected infection in the first 3 days of life; all babies also received tobramycin or cefotaxime (dosage regimens not reported)

Number of studiesProportion of simulated babies (n = 10,000 simulations on 167 samples from 20 babies)* receiving 50,000 IU/kg of benzylpenicillin every 12 hoursEffectQuality
Relative (95% confidence interval)Absolute (95% confidence interval)
Pharmacokinetics
Probability of target attainment for pathogens with MICs of4 mg/l, using Monte Carlo simulation (with the assumption that in preterm babies, at least 50% of the time, the concentration of benzylpenicillin remains above the MIC)a
1
(Muller 2007)
100%--Very low
a

The estimates of the pharmacokinetic parameters and measures of dispersion from the study were used to simulate various dosing regimens and obtain the percent fT > MIC as a function of MIC. The simulated subjects were based on 167 data points from 20 patients and reasonable, justified, gestational-age appropriate assumptions about the variability between babies. A Monte Carlo simulation takes repeated samples (n=10,000) from these distributions to give the result reported

See the complete GRADE Table J 9.14

From: 9, Antibiotics for suspected infection

Cover of Antibiotics for Early-Onset Neonatal Infection
Antibiotics for Early-Onset Neonatal Infection: Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection.
NICE Clinical Guidelines, No. 149.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Aug.
Copyright © 2012, National Collaborating Centre for Women’s and Children’s Health.

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