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Absorption of chloramphenicol sodium succinate after intramuscular administration in children
Insights
Intramuscular chloramphenicol sodium succinate demonstrates good absorption in children, comparable to intravenous administration. This finding supports intramuscular use as a cost-effective and safer alternative for pediatric chloramphenicol therapy.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Drug Administration Routes
Background:
- Chloramphenicol is an antibiotic used for serious infections.
- Concerns exist regarding the intramuscular absorption of chloramphenicol sodium succinate.
- Intravenous administration is common but carries risks.
Purpose of the Study:
- To compare blood chloramphenicol levels after intramuscular versus intravenous administration in children.
- To evaluate the bioavailability of intramuscular chloramphenicol sodium succinate.
- To assess the therapeutic range achievement with intramuscular administration.
Main Methods:
- A comparative study involving 57 children receiving chloramphenicol sodium succinate.
- Dosing of 25 mg/kg intramuscularly or intravenously every six hours.
- Measurement of peak serum chloramphenicol levels and area under the serum level curve.
Main Results:
- Peak chloramphenicol levels after intramuscular administration were within the therapeutic range (10-30 µg/mL).
- Area under the serum level curve was not significantly different between intramuscular and intravenous routes.
- Intramuscular administration achieved therapeutic drug levels effectively.
Conclusions:
- Chloramphenicol sodium succinate is well-absorbed following intramuscular administration in children.
- Intramuscular administration is a viable, cost-effective, and potentially safer alternative to intravenous therapy.
- This route reduces staff time and risks associated with IV therapy, such as sepsis and overhydration.
Abstract:
Because it is thought that chloramphenicol is poorly absorbed after intramuscular administration, we compared blood levels of chloramphenicol after intramuscular administration with those after intravenous administration in children with a variety of diagnoses. Fifty-seven children were studied on 62 occasions while they were receiving chloramphenicol sodium succinate (25 mg of chloramphenicol per kilogram of body weight) intramuscularly every six hours. The peak level of chloramphenicol was 19.5 +/- 5.99 micrograms per milliliter (mean +/- S.D.) in 11 children after the first dose and 31.4 +/- 12.99 micrograms per milliliter in 51 children after two or more doses. The lowest peak level after intramuscular administration was 13 micrograms per milliliter, which is in the therapeutic range of 10 to 30 micrograms per milliliter. Thirteen children were studied on 17 occasions while they were receiving chloramphenicol sodium succinate (25 mg of chloramphenicol per kilogram) intravenously every six hours. The peak level of chloramphenicol was 19.4 +/- 6.37 micrograms per milliliter in eight children after the first dose and 28.2 +/- 11.09 micrograms per milliliter in nine children after two or more doses. The area under the serum level curve was not significantly different after intramuscular and intravenous administration. We conclude that chloramphenicol sodium succinate is well absorbed after intramuscular administration. This route is cheaper, it demands less staff time, and it does not carry the risks of sepsis and overhydration associated with intravenous therapy.