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[Experimental and clinical evaluation of a new cephamycin antibiotic, cefotetan, in pediatrics]
Insights
Cefotetan (CTT) demonstrates potent activity against pediatric bacterial infections, including resistant strains. This antibiotic shows favorable pharmacokinetic properties and achieved a 97% efficacy rate in treating various acute pediatric infections.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and pharmacokinetics
- Antimicrobial susceptibility testing
Context:
- Bacterial infections are a significant concern in pediatric populations.
- The emergence of antibiotic resistance necessitates the evaluation of novel therapeutic agents.
- Cefotetan (CTT) is a cephalosporin antibiotic with potential applications in pediatric care.
Purpose:
- To evaluate the efficacy and pharmacokinetic profile of cefotetan (CTT) in pediatric patients.
- To determine the minimum inhibitory concentrations (MICs) of CTT against common pediatric bacterial pathogens.
- To compare the pharmacokinetic properties of CTT with other cephalosporins like CFX and CMZ.
Summary:
- Cefotetan (CTT) exhibited low MICs (≤0.78 µg/ml) against E. coli and K. oxytoca from pediatric isolates, including ampicillin-resistant strains.
- Pharmacokinetic studies showed CTT achieved higher peak serum concentrations and longer half-lives (≥2 hours) compared to CFX and CMZ.
- Therapeutic administration of CTT in 37 pediatric patients with acute infections resulted in a 97% efficacy rate, with dosages ranging from 20-40 mg/kg/day.
Impact:
- Cefotetan (CTT) demonstrates promising efficacy and favorable pharmacokinetics for treating acute pediatric infections.
- The drug effectively penetrates the cerebrospinal fluid and inhibits enteric pathogens in the feces.
- CTT represents a valuable therapeutic option for pediatric bacterial infections, including those caused by resistant organisms.
Abstract:
A series of studies was performed on the use of cefotetan (CTT) in the field of pediatrics. The results that were obtained are described below. The minimum inhibitory concentrations (MICs) of CTT against strains of E. coli and K. oxytoca that were recently isolated from child patients were found to mostly be 0.78 micrograms/ml or less. Even strains that were highly resistant to the action of ABPC were sensitive to CTT. CTT was administered to pediatric patients by intravenous drip infusion or by one shot intravenous injection, and then the concentration of the drug in the serum was monitored. The same procedures and dosages were employed for CFX and CMZ. In comparison with these 2 antibiotics, CTT showed a higher peak concentration in the serum, and it was retained in the blood for a longer time. The half-life of the CTT serum concentration was 2 hours or more in most of the subjects. When CTT was administered in a dosage of 10 mg/kg by intravenous drip infusion, the drug could still be detected in the serum as long as 12 hours later in some cases. Repeated intravenous drip infusion administration of CTT was not found to result in any accumulation of this antibiotic in the serum. During the 8-hour period following intravenous injection of CTT, about 50 to 80% of the administered dose was found to be excreted in the urine in its active form. During the acute phase of meningitis, intravenously injected (one shot) CTT was found to be transferred to the cerebrospinal fluid in a concentration that was sufficient to kill those bacteria that were sensitive to the action of this antibiotic. It was proven that, following the intravenous injection of CTT, the concentration of this drug in the feces was sufficient to inhibit the growth of Salmonella, Campylobacter, etc. CTT was administered by intravenous drip infusion as therapy to a total of 37 child patients diagnosed as having acute infections; these infections consisted mainly of upper and lower respiratory tract infections, urinary tract infections, intestinal tract infections and suppurative diseases. The dosage of CTT used in the treatment of these diseases ranged almost from 20 to 40 mg/kg/day, given as 2 doses per day (at intervals of 10-12 hours). The efficacy rate of this therapeutic regimen was 97%.(ABSTRACT TRUNCATED AT 400 WORDS)