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Ceftazidime in neonatal infections

D C Low, J G Bissenden, R Wise

    Archives of Disease in Childhood
    |April 1, 1985
    PubMed

    Insights

    Ceftazidime showed high serum concentrations and good cerebrospinal fluid penetration in neonates. However, it was ineffective against Gram-positive organisms, limiting its use as monotherapy before culture results are known.

    Area of Science:

    • Neonatal pharmacology
    • Infectious diseases
    • Antibiotic therapy

    Background:

    • Neonatal infections require effective and safe antibiotic treatment.
    • Ceftazidime is a broad-spectrum cephalosporin with theoretical suitability for neonatal use.
    • Limited data exist on ceftazidime efficacy and safety in neonates.

    Purpose of the Study:

    • To evaluate the efficacy and safety of intravenous ceftazidime in neonates with suspected or proven infections.
    • To assess ceftazidime serum concentrations, cerebrospinal fluid penetration, and clinical outcomes.

    Main Methods:

    • A prospective study of 91 neonates receiving 108 courses of intravenous ceftazidime (25 mg/kg, 12-hourly).
    • Clinical and bacteriological data were collected for 14 neonates with proven infections.
    • Serum drug concentrations and cerebrospinal fluid penetration were monitored.

    Main Results:

    • High serum ceftazidime concentrations were achieved, exceeding minimum inhibitory concentrations for common pathogens.
    • Excellent cerebrospinal fluid penetration was observed in 8 of 9 cases.
    • Four neonates with Gram-positive infections (Group B Streptococcus, Staphylococcus aureus) failed to respond.
    • Nine neonates showed clinical improvement or bacteriological eradication, with no observed side effects.

    Conclusions:

    • Ceftazidime demonstrates favorable pharmacokinetic properties in neonates, including high serum levels and CSF penetration.
    • The antibiotic was effective against Gram-negative infections but ineffective against Gram-positive organisms in this study.
    • Ceftazidime cannot be recommended as monotherapy for neonatal infections until bacteriological culture results are available.

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