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Efficacy and pharmacokinetics of Timentin in paediatric infections
Insights
Timentin (ticarcillin and clavulanic acid) showed good tolerance and clinical success in treating bacterial infections in hospitalized children. This antibiotic may be a valuable first-line option for pediatric infections.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacokinetics and Drug Metabolism
- Antimicrobial Therapy
Background:
- Ticarcillin-resistant bacteria pose a challenge in pediatric infections.
- Timentin, a combination of ticarcillin and clavulanic acid, offers a potential treatment option.
- Understanding Timentin's efficacy and pharmacokinetics in children is crucial for optimizing its use.
Purpose of the Study:
- To evaluate the clinical efficacy of Timentin in pediatric patients.
- To assess the pharmacokinetic profile of Timentin in newborns and children.
- To determine appropriate dosing strategies for Timentin in different pediatric age groups.
Main Methods:
- A clinical study involving 24 children treated with Timentin.
- Pharmacokinetic analysis of ticarcillin and clavulanic acid serum concentrations in newborns and children.
- Dosage adjustments based on age and pharmacokinetic data.
Main Results:
- Full clinical success was achieved in 16 out of 24 children, including cases of pyelonephritis and neonatal infections.
- Pharmacokinetic data showed adequate serum concentrations of ticarcillin and clavulanic acid.
- Timentin demonstrated good tolerance with favorable pharmacokinetic profiles in both newborns and older children.
Conclusions:
- Timentin is a potentially effective first-line antibiotic for hospitalized children with bacterial infections.
- The study supports the use of Timentin at described dosages (225-250 mg/kg/d ticarcillin, 9-16 mg/kg/d clavulanic acid).
- Further investigation into Timentin's role in specific pediatric infections is warranted.
Abstract:
Twenty-four children, ten of whom had an infection due to ticarcillin-resistant, Timentin-sensitive bacteria, were treated with Timentin. A full clinical success was obtained in sixteen cases (13 pyelonephritis, nine of them due to ticarcillin-resistant, Timentin-sensitive Escherichia coli, two neonatal infections and one pneumonia). Four children were improved (1 bronchiectasis, 3 leukaemias), three were unassessable and one failure occurred with a staphylococcal urinary tract infection. A pharmacokinetic study was performed in three newborns (under three months) and ten children (mean age 3 years). Timentin was administered as four daily 30-min iv infusions. The mean dosage used in patients under three months was 225 mg/kg/d ticarcillin and 9 mg/kg/d clavulanic acid. In infants older than three months of age the mean dosage was 250 mg/kg/d ticarcillin and 16 mg/kg/d clavulanic acid. The pharmacokinetic results demonstrated similar serum concentrations of ticarcillin to those in earlier studies, and serum concentrations of clavulanic acid of 3.1 +/- 0.63 mg/l and 2.18 +/- 0.17 mg/l at 1 h and 2 h respectively after infusion in newborns. For children, at the same times, the serum levels were respectively 2.3 +/- 0.9 mg/l and 1.4 +/- 0.9 mg/l. The peak serum concentrations of clavulanic acid were the same in the two groups of dosages (4.7 mg/l), but the half-lives of clavulanic acid were 1.1 h in children older than three months and 1.8 h in infants younger than 3 months. The tolerance was good. Timentin may be useful as a first line antibiotic in infections in hospitalized children in the dosage described, as three or four injections daily, according to the age and the severity of the disease.