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Ceftizoxime disposition in neonates and infants during the first six months of life
M D Reed1, W M Gooch, S D Minton
1Division of Pediatric Pharmacology and Critical Care, University of Virginia, Charlottesville 22908.
Insights
Ceftizoxime pharmacokinetics in neonates and infants show age-dependent changes. Dosing recommendations are provided to ensure safe and effective ceftizoxime use in pediatric patients.
Area of Science:
- Pharmacology
- Pediatric Medicine
- Antibiotic Research
Background:
- Ceftizoxime is a third-generation cephalosporin antibiotic.
- Understanding its pharmacokinetics in neonates and infants is crucial for appropriate dosing.
- Previous pharmacokinetic data in this age group is limited.
Purpose of the Study:
- To investigate the single-dose pharmacokinetics of ceftizoxime sodium in neonates and infants.
- To evaluate the influence of age on ceftizoxime pharmacokinetic parameters.
- To establish age-appropriate dosing guidelines for ceftizoxime in pediatric patients.
Main Methods:
- Pharmacokinetic study involving 52 neonates and infants (0.1-189 days).
- Administration of ceftizoxime sodium at 25 or 50 mg/kg intravenously.
- Analysis of pharmacokinetic parameters including half-life, clearance, and volume of distribution relative to age.
Main Results:
- Ceftizoxime pharmacokinetics varied significantly with infant age.
- Half-life and mean residence time decreased, while body clearance increased with age.
- Volume of distribution remained constant across age groups.
- No adverse effects were observed during the study.
Conclusions:
- Age is a significant factor influencing ceftizoxime pharmacokinetics in neonates and infants.
- Recommended dosing: 50 mg/kg every 12 hours for infants ≤2 weeks (≤40 weeks postconceptional age).
- Recommended dosing: 50 mg/kg every 8 hours for older infants.
Abstract:
The single-dose pharmacokinetics of ceftizoxime sodium were studied in 52 neonates and infants between 0.1 and 189 days of age. Subjects received ceftizoxime 25 or 50 mg/kg iv over 15-30 minutes. The drug was administered q8-12h for five days to permit tolerance evaluation on repetitive dosing. No differences were observed in ceftizoxime pharmacokinetic parameter estimates relative to dose. However, marked differences were observed in ceftizoxime pharmacokinetic characteristics relative to infant age; ceftizoxime half-life and mean residence time decreased, whereas body clearance increased with infant age. Ceftizoxime volume of distribution remained relatively constant over infant age. No adverse effects associated with ceftizoxime administration were observed. These data suggest that ceftizoxime 50 mg/kg q12h be used for infants less than or equal to 2 weeks of age (less than or equal to 40 weeks postconceptional age) and that 50 mg/kg q8h be administered for older infants.