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[Clinical evaluation of ceftazidime in paediatrics]
Insights
Ceftazidime (CAZ) demonstrates high efficacy in treating pediatric infections, with an 88.2% success rate across various conditions including meningitis and septicemia. This injectable cephalosporin shows favorable pharmacokinetic profiles and manageable side effects in children.
Area of Science:
- Pharmacology
- Pediatrics
- Infectious Diseases
Context:
- Ceftazidime (CAZ) is a third-generation cephalosporin antibiotic.
- Pediatric infections require effective and safe therapeutic options.
- Understanding the pharmacokinetic and clinical efficacy of CAZ in children is crucial.
Purpose:
- To evaluate the clinical efficacy and safety of Ceftazidime (CAZ) in pediatric patients.
- To determine the pharmacokinetic profile of CAZ in children, including blood and cerebrospinal fluid (CSF) levels.
- To assess the treatment outcomes for various infections treated with CAZ.
Summary:
- Ceftazidime (CAZ) was administered to pediatric patients with diverse infections, including meningitis, pneumonia, and enteritis.
- Pharmacokinetic studies showed varying blood and CSF concentrations of CAZ, with half-lives ranging from 1.37 to 2.96 hours.
- An overall clinical efficacy rate of 88.2% was observed, with excellent responses in severe cases like P. aeruginosa septicemia and purulent meningitis.
- Reported side effects were generally mild and transient, primarily allergic reactions and transient elevations in liver enzymes.
Impact:
- Ceftazidime (CAZ) is a viable and effective antibiotic for treating a range of pediatric bacterial infections.
- The study provides valuable data on CAZ dosing, pharmacokinetics, and clinical outcomes in a pediatric population.
- Findings support the use of CAZ in pediatric infectious disease management, particularly for severe infections.
Abstract:
Ceftazidime ( CAZ ), a new injectable cephem antibiotic, was used for treatment of infections in children, and the following results were obtained. After an intravenous injection of CAZ at a dose of 20 mg/kg, the mean blood levels in 2 patients were 41.5 micrograms/ml at 30 minutes, 18.1 micrograms/ml at 2 hours and 2.55 micrograms/ml at 6 hours, with the half-life (T 1/2) of 1.37 hours. In a 22-day-old baby with meningitis given CAZ intravenously at a dose of 43.5 mg/kg, the blood levels were 100 micrograms/ml at 30 minutes, 68 micrograms/ml at 2 hours and 25 micrograms/ml at 6 hours, with the half-life (T 1/2) of 2.96 hours. After intravenous administration of CAZ in doses ranging from 35.7 to 50 mg/kg, CSF concentrations ranged from N.D. to 6.3 micrograms/ml in 3 patients with purulent meningitis, although 19 micrograms/ml at 1 hour and 13 micrograms/ml at 2 hours in 1 patient after intravenous administration of 46.7 mg/kg. In patient with mumps meningitis, CSF concentrations were undetectable after intravenous administration of 35.7 mg/kg. Seventeen patients (each 1 patient with lymphadenitis, tonsillitis and septicemia, each 2 patients with pneumonia, bronchiectatic bronchitis, pyothorax and purulent meningitis, each 3 patients with pyelonephritis and enteritis) were treated with CAZ intravenously, at the daily doses of 178.2 mg/kg and 200 mg/kg in 4 divided doses in patients with meningitis and 44.1 to 103.4 mg/kg in 3 divided doses in patients with other infections (two of them were given by intravenous drip infusion for 30 minutes). The clinical responses were excellent or good in all the patients except for 1 case of Salmonella enteritis (poor) and 1 case of Campylobacter enteritis (poor). The efficacy rate was 88.2%. It was noteworthy that the clinical response was excellent in 1 case of septicemia with P. aeruginosa with leukemic stage of malignant lymphoma and in 2 cases of purulent meningitis. As side effects, fever, eruption, leukocytopenia, elevation in GOT and positive CRP considered to be allergic, were observed on day 16 of administration in 1 case of pyothorax. These symptoms disappeared by discontinuance of administration. In addition, there were elevation in GOT and GPT in 2 cases and elevation in GOT in 2 cases and elevation in GPT in 1 case; they were all mild or transient, and there was nothing to be worried about.(ABSTRACT TRUNCATED AT 400 WORDS)