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[Laboratory and clinical studies on ceftazidime in the field of pediatrics]
Insights
Ceftazidime (CAZ) demonstrates potent antibacterial activity against common pediatric pathogens and favorable pharmacokinetic profiles. Clinical trials show high efficacy (97.6%) in treating pediatric bacterial infections with minimal adverse effects.
Area of Science:
- Pediatric infectious diseases
- Antibiotic research and development
- Pharmacokinetics and pharmacodynamics
Context:
- Ceftazidime (CAZ) is a novel cephem antibiotic evaluated for pediatric use.
- Comparative analysis of CAZ's antibacterial spectrum against other key antibiotics.
Purpose:
- To assess the antibacterial efficacy of ceftazidime (CAZ) against clinically isolated pediatric bacterial strains.
- To determine the pharmacokinetic properties and safety profile of CAZ in pediatric patients.
- To evaluate the clinical utility of CAZ in treating various pediatric bacterial infections.
Summary:
- CAZ exhibits strong activity against Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, and Pseudomonas aeruginosa, comparable to established antibiotics.
- Pharmacokinetic studies show effective serum concentrations and urinary excretion, with a prolonged half-life in renal impairment.
- Cerebrospinal fluid penetration was demonstrated in a case of purulent meningitis.
- Clinical treatment of 42 pediatric patients resulted in a high efficacy rate (97.6%) with only mild, infrequent adverse events like diarrhea.
Impact:
- Ceftazidime (CAZ) is a valuable and safe therapeutic option for managing bacterial infections in children.
- The study supports the use of CAZ in pediatric settings, particularly for serious infections like meningitis.
- Demonstrates the potential of CAZ as a first-line treatment in pediatric infectious disease management.
Abstract:
Laboratory and clinical studies on ceftazidime ( CAZ ), a new cephem antibiotic, were carried out in the field of pediatrics. The results were as follows: Antibacterial activities of CAZ against clinically isolated strains of S. pneumoniae, H. influenzae, E. coli and P. aeruginosa were compared with those of cefotaxime (CTX), ceftizoxime (CZX), latamoxef ( LMOX ), cefoperazone (CPZ) and cefmetazole (CMZ), and also with cefsulodin (CFS) and gentamicin (GM) against P. aeruginosa. Against S. pneumoniae and H. influenzae, CAZ was almost as active as CTX, CZX and CPZ. Against E. coli, it was almost as active as CTX, CZX and LMOX . Against P. aeruginosa, it was almost as active as CFS and GM. Serum concentrations and urinary excretion rates after intravenous bolus injection of CAZ at doses of 20 mg/kg and 10 mg/kg for 5 minutes in each 2 cases (4 cases in total) were determined. The mean serum concentrations of CAZ were 78.9 and 52.0 micrograms/ml at 15 minutes, 38.5 and 27.4 micrograms/ml at 1 hour, and 6.5 and 4.8 micrograms/ml at 4 hours, with serum half-lives (T 1/2) of 1.39 and 1.80 hours respectively. Mean cumulative urinary excretion rate within 6 hours after administration was 84.6%. In a patient with chronic renal failure, serum half-life was 3.22 hours and urinary excretion rate within 6 hours was 22.8% (after intravenous bolus injection of CAZ at a dose of 10 mg/kg). CAZ was administered at a dose of 55.5 mg/kg by intravenous bolus injection to a child with purulent meningitis. The levels of CAZ in the cerebrospinal fluid (CSF) at 1 hour after administration were 2.7-38.9 micrograms/ml with CSF/Serum ratios of 3.2-28.8%. Forty-two pediatric patients with various bacterial infections (pyelonephritis 14, tonsillitis 1, bronchopneumonia 3, pneumonia 17, purulent meningitis 1, bacteremia 2, SSSS 1, enterocolitis 3) were treated with CAZ at a daily dose of 49-222 mg/kg t.i.d. or q.i.d. (as a rule 60 mg/kg t.i.d.). The efficacy rate was 97.6% clinically and 97.8% bacteriologically. No adverse reactions were observed except 1 case with mild diarrhea. Abnormal laboratory findings were also only mild; eosinophilia in 1, slight elevation of GOT in 5 and that of GOT & GPT in 3 cases. These results indicate the usefulness of CAZ in the treatment of bacterial infections in children.