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Pharmacology of some oral penicillins in the newborn infant

M D Cohen, J A Raeburn, J Devine

    Archives of Disease in Childhood
    |March 1, 1975
    PubMed

    Insights

    Newborn infants show delayed absorption of oral ampicillin, amoxycillin, and flucloxacillin. Initial intramuscular antibiotic doses are recommended, followed by oral therapy for satisfactory therapeutic drug concentrations.

    Area of Science:

    • Pharmacology
    • Neonatal Medicine
    • Infectious Diseases

    Background:

    • Antibiotic therapy in neonates requires careful consideration of drug absorption and efficacy.
    • Ampicillin, amoxycillin, and flucloxacillin are commonly used antibiotics.
    • Neonatal physiology can impact drug pharmacokinetics, including absorption.

    Purpose of the Study:

    • To measure serum and urine concentrations of ampicillin, amoxycillin, and flucloxacillin after oral administration in newborn infants.
    • To compare antibiotic absorption in neonates with that in adults and children.
    • To provide recommendations for optimal antibiotic dosing strategies in infected newborns.

    Main Methods:

    • Oral administration of ampicillin, amoxycillin, and flucloxacillin to 27 newborn infants.
    • Measurement of serum and urine antibiotic concentrations.
    • Comparison of pharmacokinetic profiles between neonates and other age groups.

    Main Results:

    • Newborn infants exhibit delayed absorption of oral antibiotics compared to adults and children.
    • Most neonates achieve therapeutic serum antibiotic concentrations.
    • The enhanced absorption of amoxycillin over ampicillin observed in adults was not confirmed in neonates.

    Conclusions:

    • Initial intramuscular antibiotic dosing is advised for infected newborns.
    • Subsequent oral antibiotic therapy (25 mg/kg every 6 hours) is generally satisfactory after the first dose.
    • Antibiotic absorption and dosing regimens may need specific adjustments for the neonatal population.

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