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[Fundamental and clinical studies of sulbactam/cefoperazone in the pediatric field]
Insights
This study evaluated sulbactam/cefoperazone (SBT/CPZ) in pediatric patients, finding it effective against common Gram-negative and Gram-positive bacteria. Pharmacokinetic data supports its use in pediatric infections.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Sulbactam/cefoperazone (SBT/CPZ) is a combination antibiotic used to treat bacterial infections.
- Pediatric antibiotic therapy requires careful consideration of efficacy and pharmacokinetics.
Observation:
- SBT/CPZ demonstrated potent in vitro activity against key pediatric pathogens including E. coli, Salmonella, Klebsiella, and S. aureus.
- The combination showed enhanced activity compared to cefoperazone alone, particularly against resistant strains.
Findings:
- Pharmacokinetic studies in pediatric patients revealed dose-dependent serum concentrations of SBT and CPZ following intravenous administration.
- Half-lives for both drugs were determined for bolus infusion and drip infusion, providing crucial data for dosing regimens.
Implications:
- The findings support the clinical utility of SBT/CPZ in treating pediatric bacterial infections.
- Understanding the pharmacokinetic profile of SBT/CPZ in children is essential for optimizing therapeutic outcomes and minimizing resistance.
Abstract:
Fundamental and clinical studies were carried out on sulbactam/cefoperazone (SBT/CPZ) in the field of pediatrics. The following results were obtained: A total of 185 clinical isolates that had been stocked at our department was employed to determine the minimum inhibitory concentrations (MICs) of SBT/CPZ against various bacterial species. SBT/CPZ showed strong antibacterial potency against E. coli, Salmonella, Klebsiella and P. mirabilis, and relatively strong potency against S. marcescens, P. aeruginosa and S. aureus. Antibacterial potency of SBT/CPZ was stronger than that of CPZ alone against E. coli, and it also showed strong activity against strains of Salmonella, S. marcescens and S. aureus, moderately or highly resistant to CPZ. SBT/CPZ was administered by intravenous bolus infusion to pediatric patients to determine the serum concentrations of SBT and CPZ. At a dose of 10 mg/kg the mean serum levels of SBT and CPZ were as follows; 17.8 micrograms/ml, 40.7 micrograms/ml at 15 minutes and 0.3 microgram/ml at 6 hours, respectively. The half-lives of SBT and CPZ in the serum were 1.05 hours and 1.76 hours, respectively. Similarly, at a dose of 20 mg/kg the mean serum levels of SBT and CPZ were; 31.9 micrograms/ml, 81.0 micrograms/ml at 15 minutes and 0.5 microgram/ml, 6.1 micrograms/ml at 6 hours, and the half-lives were 1.00 hour and 1.72 hours, respectively. At a dose of 40 mg/kg, only 1 case was determined. The serum levels of SBT and CPZ were 34.4 micrograms/ml, 74.8 micrograms/ml at 30 minutes and 0.2 microgram/ml at 6 hours, and the half-lives were 0.78 hour and 1.38 hours, respectively. SBT/CPZ was drip-infused intravenously over a period of 1 hour, and the serum concentrations of SBT and CPZ were determined. At the dose of 10 mg/kg or 20 mg/kg, the peak serum levels of SBT and CPZ were observed at 1 hour or at the end of drip infusion. At a dose of 10 mg/kg the mean serum levels of SBT and CPZ were 14.4 micrograms/ml, 33.7 micrograms/ml at 1 hour and 1.4 micrograms/ml, 4.6 micrograms/ml at 7 hours, respectively. The half-lives was 1.86 hours for SBT and 2.23 hours for CPZ, respectively. Similarly at a dose of 20 mg/kg, the mean serum levels of SBT and CPZ were, 22.2 micrograms/ml, 34.6 micrograms/ml at 1 hour and 0.5 microgram/ml, 2.8 micrograms/ml at 7 hours, and the half-lives was 1.17 hours and 1.75 hours, respectively. The urinary recovery rate was determined for the 6 hours period after administration.(ABSTRACT TRUNCATED AT 400 WORDS)