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Intravenous Injections in Neonatal Mice
05:17

Intravenous Injections in Neonatal Mice

Published on: November 11, 2014

Pharmacokinetics of intravenous clindamycin in newborn infants

G Koren, Y Zarfin, D Maresky

    Pediatric Pharmacology (New York, N.Y.)
    |January 1, 1986
    PubMed

    Insights

    Newborn infants receiving clindamycin phosphate for serious infections showed higher serum concentrations than therapeutic ranges. Reduced dosing to 15-20 mg/kg/day is recommended due to prolonged elimination half-life and lower clearance in neonates.

    Area of Science:

    • Neonatal pharmacology
    • Infectious disease in neonates
    • Pharmacokinetics in newborns

    Background:

    • Necrotizing enterocolitis and anaerobic septicemia are serious conditions in newborns.
    • Clindamycin phosphate is used to treat these infections.
    • Limited pharmacokinetic data exists for clindamycin in neonates.

    Purpose of the Study:

    • To evaluate clindamycin pharmacokinetics in newborn infants.
    • To determine appropriate dosing for clindamycin in this population.
    • To compare neonatal clindamycin parameters to older children and adults.

    Main Methods:

    • Studied 12 newborn infants with suspected or proven necrotizing enterocolitis or anaerobic septicemia.
    • Administered clindamycin phosphate at 3.2-11 mg/kg every six hours.
    • Measured serum concentrations, elimination half-life (T1/2), and clearance at steady state.

    Main Results:

    • Mean serum clindamycin concentrations ranged from 12.7 to 40 µg/ml, exceeding the therapeutic range of 2-10 µg/ml.
    • Elimination T1/2 was 6.3 ± 2.1 hours, 100% longer than in older children/adults.
    • Clindamycin clearance was 61.6 ± 31.6 hr ml/kg/hr, lower than in older children/adults.

    Conclusions:

    • Neonatal clindamycin pharmacokinetics differ significantly from older populations.
    • Prolonged T1/2 and reduced clearance necessitate dose adjustment.
    • Recommended IV clindamycin dose for neonates is 15-20 mg/kg/day in four divided doses.

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