Related Experiment Video

Updated: Dec 31, 2025

Longitudinal Follow-Up of Urinary Tract Infections and Their Treatment in Mice using Bioluminescence Imaging
07:39

Longitudinal Follow-Up of Urinary Tract Infections and Their Treatment in Mice using Bioluminescence Imaging

Published on: June 14, 2021

3.4K

High Direct Bilirubin Associated With Levoffoxacin Use in a Neonate

Amy P Holmes, Charles E Hartis, Laurie J Rollins

    The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
    |January 4, 2020
    PubMed

    Insights

    Levofloxacin successfully treated Stenotrophomonas maltophilia tracheitis in a premature infant. However, this antibiotic use was linked to a sudden increase in direct bilirubin, indicating a potential adverse drug effect in neonates.

    Area of Science:

    • Neonatal pharmacology
    • Infectious diseases
    • Clinical toxicology

    Background:

    • Limited data exist on fluoroquinolone use in neonates.
    • Levofloxacin exhibits activity against Stenotrophomonas maltophilia, an important pathogen in neonatal infections.
    • Stenotrophomonas maltophilia tracheitis is a serious condition in premature infants.

    Observation:

    • A premature neonate with S. maltophilia tracheitis was treated with levofloxacin (10 mg/kg every 24 hours).
    • Successful treatment of the tracheitis was observed.
    • A concurrent, sharp, and unexpected rise in direct bilirubin levels was noted.

    Findings:

    • Levofloxacin demonstrated efficacy in treating S. maltophilia tracheitis in a premature neonate.
    • Levofloxacin administration was associated with a significant increase in direct hyperbilirubinemia.
    • This suggests a potential, previously undocumented adverse drug reaction of levofloxacin in neonates.

    Implications:

    • Levofloxacin may cause cholestatic jaundice in neonates.
    • Clinicians should monitor direct bilirubin levels in neonates receiving levofloxacin.
    • Further research is warranted to elucidate the mechanism and incidence of this adverse effect.

    Keywords:
    Stenotrophomas maltophiliaadverse drug eventhyper-direct bilirubinemialevofloxacinneonate

    More Related Videos

    A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis08:46

    A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

    Published on: August 12, 2020

    6.8K
    Isolation of Neonatal Extrahepatic Cholangiocytes07:54

    Isolation of Neonatal Extrahepatic Cholangiocytes

    Published on: June 5, 2014

    10.7K

    Related Concept Videos

    Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

    Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

    Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
    191
    Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

    Pharmacokinetics in Pediatric Patients: Drug Metabolism

    In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
    152
    Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

    Pharmacokinetics in Pediatric Patients: Drug Excretion

    In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
    168
    Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

    Pharmacokinetics in Pediatric Patients: Drug Distribution

    Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
    209
    Drug Dosing: Infants and Children01:29

    Drug Dosing: Infants and Children

    Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
    202
    Hepatic Drug Excretion: Influencing Factors01:16

    Hepatic Drug Excretion: Influencing Factors

    The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
    481