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Pharmacokinetics of ceftazidime in newborn infants
Insights
Ceftazidime (50 mg/kg) given intravenously to newborn infants achieved therapeutic plasma concentrations and bactericidal titers against common pathogens. Dosing every 8 or 12 hours demonstrated efficacy in this vulnerable population.
Area of Science:
- Neonatal pharmacology
- Pediatric infectious diseases
- Antibiotic pharmacokinetics
Background:
- Neonates are susceptible to serious bacterial infections.
- Ceftazidime is a third-generation cephalosporin antibiotic with broad-spectrum activity.
- Optimizing antibiotic dosing in neonates is crucial for efficacy and safety.
Purpose of the Study:
- To evaluate the pharmacokinetic profile of ceftazidime in newborn infants.
- To determine the plasma bactericidal activity of ceftazidime in this population.
- To assess the relationship between ceftazidime pharmacokinetics and patient factors like gestational age.
Main Methods:
- Intravenous administration of ceftazidime (50 mg/kg) to 29 newborn infants.
- Dosing intervals of every 8 or 12 hours for 3 to 5 days.
- Measurement of plasma concentrations, elimination half-life, and plasma clearances.
- Assay of peak and trough plasma bactericidal titers against Escherichia coli and group B Streptococcus.
Main Results:
- Mean peak plasma concentrations ranged from 102 to 124 micrograms/ml.
- Mean elimination half-life varied from 2.9 to 6.7 hours, inversely correlating with gestational age.
- Plasma clearances showed inverse variation with gestational age.
- Achieved plasma bactericidal titers were consistently high (≥1:16 peak, ≥1:32 trough).
Conclusions:
- Ceftazidime administered at 50 mg/kg achieves adequate plasma concentrations and bactericidal activity in newborn infants.
- Pharmacokinetics are influenced by gestational age, with longer half-lives in younger infants.
- The dosing regimen appears effective for treating susceptible bacterial infections in neonates.
Abstract:
Doses of 50 mg of ceftazidime per kg were administered intravenously to 29 newborn infants every 8 or 12 h for 3 to 5 days. Mean peak concentrations in plasma ranged from 102 to 124 micrograms/ml. Mean elimination half-life values ranged from 2.9 to 6.7 h and varied inversely with gestational age and plasma clearances. Peak and trough plasma bactericidal titers against an Escherichia coli and a group B streptococcus strain were at least 1:16 and 1:32, respectively.