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[Clinical evaluation of cefotetan in pediatrics]
Insights
Cefotetan (CTT) is a safe and effective antibiotic for children with bacterial infections, showing 77.3% efficacy. A twice-daily dose is recommended due to its long half-life.
Area of Science:
- Pharmacology
- Pediatric Infectious Diseases
Context:
- Cefotetan (CTT) is a novel cephamycin antibiotic.
- Long serum half-life of CTT (2.93 +/- 0.78 hours) suggests potential for less frequent dosing.
Purpose:
- To evaluate the safety and efficacy of Cefotetan (CTT) in pediatric patients.
- To determine optimal dosing and identify susceptible pathogens.
Summary:
- Twenty-four children received CTT (30-100 mg/kg/day IV), achieving 77.3% effectiveness against infections like bronchitis, pneumonia, and UTIs.
- Effective against S. pneumoniae, H. influenzae, E. coli, and others; less effective in staphylococcal infections and Pseudomonas pneumonia.
- Mild adverse effects included diarrhea and transient liver enzyme elevations; no severe reactions were noted. CSF levels were lower compared to other cephalosporins.
Impact:
- Cefotetan (CTT) demonstrates a favorable safety profile and significant efficacy in treating pediatric bacterial infections.
- Supports the use of Cefotetan (CTT) in children, with a recommended twice-daily administration schedule.
- Highlights the need for susceptibility testing, especially for Gram-positive and Pseudomonas infections.
Abstract:
Cefotetan (CTT), a new cephamycin antibiotic having a long serum half-life (2.93 +/- 0.78 hours), was evaluated for its safety and efficacy in children. Twenty-four patients were treated with a daily dose of 30 to 100 mg/kg of CTT by intravenous administrations mostly in 2 divided doses. The diagnoses of the effective patients were acute bronchitis (5), pneumonia (4), acute urinary tract infections (4), acute enterocolitis (2), presumed septicemia (1), and phlegmon (1); and the effectiveness was 77.3%. The pathogens recovered from these patients were S. pneumoniae (1), H. influenzae (3), S. marcescens (1), E. coli (2), and K. oxytoca (1). CTT was not effective in staphylococcal pneumonia and empyema (each 1 case), in Pseudomonas pneumonia (2), and in a case of brain abscess and mastoiditis of unknown etiology. Diarrhea (2), and transient elevations of the serum GOT, GPT, and LDH (1) were associated with the CTT therapy, but no severe adverse reaction was encountered. The CSF level of CTT seemed to be lower among several new cephalosporins. From the present study, CTT appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections. A twice-a-day schedule was recommended from its long serum half-life.