Population pharmacokinetics of antibacterial agents in the older population: a literature review

Expert Rev Clin Pharmacol. 2024 Jan;17(1):19-31. doi: 10.1080/17512433.2023.2295009. Epub 2024 Jan 23.

Abstract

Introduction: Older individuals face an elevated risk of developing bacterial infections. The optimal use of antibacterial agents in this population is challenging because of age-related physiological alterations, changes in pharmacokinetics (PK) and pharmacodynamics (PD), and the presence of multiple underlying diseases. Therefore, population pharmacokinetics (PPK) studies are of great importance for optimizing individual treatments and prompt identification of potential risk factors.

Area covered: Our search involved keywords such as 'elderly,' 'old people,' and 'geriatric,' combined with 'population pharmacokinetics' and 'antibacterial agents.' This comprehensive search yielded 11 categories encompassing 28 antibacterial drugs, including vancomycin, ceftriaxone, meropenem, and linezolid. Out of 127 studies identified, 26 (20.5%) were associated with vancomycin, 14 (11%) with meropenem, and 14 (11%) with piperacillin. Other antibacterial agents were administered less frequently.

Expert opinion: PPK studies are invaluable for elucidating the characteristics and relevant factors affecting the PK of antibacterial agents in the older population. Further research is warranted to develop and validate PPK models for antibacterial agents in this vulnerable population.

Keywords: Antibacterial agents; NONMEM; individualized treatment; older individuals; population pharmacokinetics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents* / pharmacokinetics
  • Bacterial Infections / drug therapy
  • Humans
  • Meropenem
  • Risk Factors
  • Vancomycin

Substances

  • Anti-Bacterial Agents
  • Meropenem
  • Vancomycin