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[Fundamental and clinical studies on ceftizoxime in pediatric field (author's transl)]
Insights
Ceftizoxime demonstrates strong in vitro activity against key pediatric pathogens, including resistant strains of E. coli and K. pneumoniae. Clinical trials show high effectiveness (92.9%) with no observed side effects in children.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Pharmacology
Background:
- Ceftizoxime is a novel cephalosporin antibiotic.
- Evaluation of ceftizoxime's efficacy and safety in pediatric patients is crucial.
Observation:
- In vitro studies showed ceftizoxime's potent activity against E. coli and K. pneumoniae, including resistant strains.
- Pharmacokinetic analysis revealed a serum half-life of 1.12 hours and significant urinary excretion.
- Clinical trials assessed treatment response in 28 children with various infections.
Findings:
- Ceftizoxime exhibited superior in vitro activity against E. coli and K. pneumoniae compared to cefazolin and cefmetazole.
- The antibiotic achieved a 92.9% overall clinical effectiveness rate and an 81.3% bacteriological eradication rate.
- No adverse clinical side effects were reported, with only minor, transient laboratory abnormalities in two patients.
Implications:
- Ceftizoxime presents a promising therapeutic option for pediatric infections caused by susceptible bacteria.
- Its favorable pharmacokinetic profile and high efficacy support its use in pediatric clinical practice.
- Further research may explore its role in treating infections caused by multidrug-resistant organisms.
Abstract:
Fundamental and clinical studies of ceftizoxime, a new cephalosporin antibiotic, in children led to the following results. 1. Ceftizoxime compared favorably with cefazolin (CEZ) and cefmetazole (CMZ) for in vitro activity against clinically isolated strains of Staphylococcus aureus (31 strains), Escherichia coli (29), Klebsiella pneumoniae (30) and Pseudomonas aeruginosa (16). While somewhat less active against S. aureus than CEZ and CMZ, ceftizoxime was far more active than these 2 cephalosporin antibiotics against the test strains of E. coli and K. pneumoniae, which included strains resistant to the 2 drugs. Ceftizoxime was not particularly active against Ps. aeruginosa, but this seeming disadvantage was offset by the absolute ineffectiveness of the 2 reference drugs on this obstinate organism. 2. The time course of mean serum ceftizoxime levels in 3 pediatric patients of 5--10 years old given a single intravenous dose of 20 mg/kg was as follows: 45.4 micrograms/ml at 15 minutes, 40.4 micrograms/ml at 30 minutes, 22.1 micrograms/ml at 1 hour, 10.4 micrograms/ml at 2 hours, 2.9 micrograms/ml at 4 hours and 0.9 microgram/ml at 6 hours. The mean serum half life was 1.12 hours. The mean urinary levels of ceftizoxime at serial 2-hour collection intervals were as follows: 2,477 micrograms/ml for 1--2 hours, 1,235 micrograms/ml for 2--4 hours and 462 micrograms/ml for 4--6 hours. The mean urinary recovery up to 6 hours was 61.0%. 3. The clinical response of 28 children with infection to ceftizoxime treatment was 'excellent' in 22 children, 'good' in 4, and 'poor' in 2. These children comprised 11 with acute pneumonia, 3 with acute bronchitis, 4 with acute pyelonephritis, 2 each with acute purulent arthritis and acute enterocolitis, and 1 each with acute purulent tonsillitis, acute purulent lymphadenitis, furunculosis, subcutaneous abscess, subdural abscess and sepsis. The overall rate of effectiveness was 92.9%. Successfully eradicated strains in the bacteriological sense consisted of 4 strains each of H. influenzae and E. coli, 1 strain each of P. morganii, S. pneumoniae and S. pyogenes, 1 of the 2 strains of S. enteritidis, and 1 of the 3 strains of S. aureus. The overall rate of bacteriological effectiveness was 81.3%. No clinical side effects were observed. Changes in laboratory test findings included slightly and transiently elevated GOT and GPT in 1 child and GOT alone in another child.