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[Pharmacokinetic and clinical studies of ceftizoxime in newborn infants]
1Department of Pediatrics, Tokyo Metropolitan Ebara General Hospital.
Insights
Ceftizoxime (CZX) pharmacokinetic studies in infants show that younger infants have higher serum concentrations and longer half-lives. This third-generation cephalosporin demonstrated excellent clinical efficacy in treating various bacterial infections in neonates and infants.
Area of Science:
- Pharmacology
- Pediatrics
- Infectious Diseases
Context:
- Neonatal and infant pharmacokinetics require specific dosing considerations due to immature organ function.
- Ceftizoxime is a broad-spectrum, third-generation cephalosporin antibiotic used for bacterial infections.
Purpose:
- To evaluate the pharmacokinetics and clinical efficacy of ceftizoxime (CZX) in infants.
- To determine the impact of infant age and administration method on CZX serum concentrations and half-life.
Summary:
- Pharmacokinetic studies in infants revealed that serum concentrations and half-lives of ceftizoxime were generally higher and longer in younger infants (≤3 days old) compared to older infants (≥5 days old).
- Urinary recovery rates of CZX were lower in younger infants.
- Clinical efficacy was excellent or good in all eleven infants treated for various bacterial infections, including meningitis and sepsis, with dosages ranging from 36-148 mg/kg/day.
Impact:
- These findings highlight the importance of age-adjusted dosing for ceftizoxime in infants to ensure therapeutic efficacy and safety.
- The study supports the use of ceftizoxime as an effective treatment option for bacterial infections in the pediatric population.
Abstract:
Pharmacokinetic and clinical studies of ceftizoxime (CZX) were performed in infants given intravenously. The obtained results are summarized as follows. 1. Serum concentrations of CZX in 2 and 3 day-old mature infants given 20 mg/kg by one shot intravenous injection peaked at 49.0 and 57.9 micrograms/ml in 1 hour and decreased to 14.4 and 24.9 micrograms/ml in 8 hours after dosing, respectively. Half-lives were 3.9 and 5.6 hours, respectively. In 5 day-old or older mature infants, peak serum levels ranged from 20.9 to 38.0 micrograms/ml at 1 hour after the injection. Levels of CZX at 8 hours after injection were 1.31 to 7.32 micrograms/ml. Half-lives were 1.6-3.0 hours in all the infants except one. 2. In a 3 day-old premature infant given the same dose by a bolus intravenous injection, the serum level peaked at 45.7 micrograms/ml in 1 hour after the injection. The level at 8 hours after injection was 15.7 micrograms/ml. The half-life was 4.2 hours. In 5-15 day-old premature infants, half-lives were 2.3-3.1 hours in all the infants except one. 3. Serum concentrations of CZX in 1 and 2 day-old infants given 20 mg/kg by intravenous drip infusion peaked at 49.4 to 115.0 micrograms/ml in 1 hour after dosing. Half-lives were rather long, 4.0 and 5.1 hours, in the 2 infants. 4. Peak serum levels and half-lives tended to be lower and shorter in 5 day-old or older ones than in the 3 day-old or younger infants. 5. No changes in the serum concentration were observed even after dosing with 20 mg/kg of continuous one shot intravenous injection. 6. Urinary recovery rates during the first 8 hours (one is 6 hours, two is 9 hours) after 20 mg/kg intravenous bolus injection of CZX tended to be lower in 3 day-old or younger infants than in 5 day-old or older infants. 7. Eleven infants with various bacterial infections were given CZX by intravenous bolus injection or drip infusion. Dosage of CZX used in the present study were 36-148 mg/kg/day in 2-3 divided doses. Duration of treatment ranged from 3 to 12 days. Clinical efficacy of CZX was excellent or good in all the infants with acute bronchitis, acute pneumonia, suspected sepsis infected in uterine, acute otitis media, cellulitis, meningitis caused by Klebsiella pneumoniae and Escherichia coli, acute urinary tract infection and periproctic abscess except 1 case of acute bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)