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)
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
(Muller 2007)
100%--Very low

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.

No part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.