Related Experiment Videos
[Fundamental and clinical studies of sulbactam/cefoperazone in the pediatric field]
Insights
This study evaluated the new sulbactam/cefoperazone (SBT/CPZ) antibiotic in children. Results showed favorable serum concentrations and half-lives, indicating potential efficacy in treating pediatric infections.
Area of Science:
- Pharmacology and Therapeutics
- Pediatric Infectious Diseases
- Antimicrobial Agents
Background:
- The newly developed sulbactam/cefoperazone (SBT/CPZ) combination antibiotic was investigated for pediatric use.
- Understanding the pharmacokinetic profile and clinical efficacy of SBT/CPZ is crucial for treating pediatric infections.
Purpose of the Study:
- To determine the serum and urinary concentrations and recoveries of sulbactam (SBT) and cefoperazone (CPZ) in children.
- To evaluate the cerebrospinal fluid and serum concentrations of SBT and CPZ in a case of purulent meningitis.
- To assess the clinical and bacteriological effects and safety of SBT/CPZ in pediatric patients.
Main Methods:
- Children were administered SBT/CPZ intravenously at doses of 20 and 40 mg/kg.
- Serum, urinary, and cerebrospinal fluid concentrations of SBT and CPZ were measured.
- Susceptibility testing was performed on 289 bacterial strains against SBT/CPZ and CPZ.
- Clinical efficacy, bacteriological response, side reactions, and laboratory abnormalities were evaluated in 47 cases.
Main Results:
- Mean serum concentrations of SBT and CPZ peaked within 5 minutes post-injection, with CPZ levels approximately 1.7 times higher than SBT levels.
- A dose-response relationship was observed for both drugs.
- Mean half-lives for SBT ranged from 0.96 to 1.01 hours, and for CPZ from 1.24 to 1.32 hours, with CPZ half-lives tending to be longer.
Conclusions:
- The study demonstrated favorable pharmacokinetic properties of SBT/CPZ in children, with dose-dependent serum concentrations and reasonable half-lives.
- These findings suggest the potential utility of SBT/CPZ for treating various pediatric infections caused by susceptible microorganisms.
Abstract:
To 6 cases of children in 2 groups of 3 each, newly developed sulbactam/cefoperazone (SBT/CPZ) was given at 20 and 40 mg/kg by intravenous bolus injection, respectively, and the serum and urinary concentrations and recoveries of SBT and CPZ were determined. To 1 case of purulent meningitis, this drug was given at 40 mg/kg by intravenous bolus injection, and the cerebrospinal fluid and serum concentrations of SBT and CPZ were determined. Susceptibility tests to SBT/CPZ and CPZ of total 289 strains were conducted; Gram-positive cocci tested consisted of 26 S. aureus strains, 20 S. pyogenes strains and 21 S. pneumoniae strains, and Gram-negative bacilli consisted of 24 H. influenzae strains, 22 E. coli strains, 26 K. pneumoniae strains, 24 E. cloacae strains, 21 E. aerogenes strains, 19 Citrobacter sp. strains, 20 S. marcescens strains, 23 P. mirabilis strains, 23 indole-positive Proteus sp. strains and 20 P. aeruginosa strains. SBT/CPZ was given to total 43 cases at a mean daily dosage of 80.4 mg/kg, in 3 or 4 divided doses (6 cases in 3 and 37 cases in 4), 1 case receiving the drug by drip infusion over 30 minutes (in 3 divided doses) and all the other 42 cases by intravenous bolus injection, for 7 days on an average. They consisted of 2 cases of tonsillitis, 1 case of otitis media, 1 case of otitis media associated with mastoiditis, 30 cases of pneumonia, 1 case of suspected septicemia, 1 case of purulent meningitis, 5 cases of urinary tract infection, 1 case of purulent lymphadenitis and 1 case of submaxillaritis. And the clinical and bacteriological effects were evaluated. Also, side reactions and laboratory examinations for abnormal values due to administration of this drug were made on 47 cases including 4 drop-outs. The following results were obtained: After administration of this drug to 2 groups of 3 children each at 20 and 40 mg/kg by intravenous bolus injection, mean serum concentrations of both SBT and CPZ reached the peaks in 5 minutes; SBT levels were 60.9 and 124.7 micrograms/ml for the 2 groups and CPZ levels were 105.0 and 214.1 micrograms/ml, respectively. In either group, CPZ levels were 1.7 times as high as SBT levels, and there was observed a dose-response in both. In the 20 mg/kg group, mean half-lives of SBT and CPZ were 0.96 and 1.24 hours, respectively, and in the 40 mg/kg group, they were 1.01 and 1.32 hours, CPZ values tending to be longer.(ABSTRACT TRUNCATED AT 400 WORDS)