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Cefoxitin in newborn infants. A clinical and pharmacokinetic study
Insights
Cefoxitin effectively treated bacterial infections in infants under two months old, with 14 of 15 patients recovering. This antibiotic showed a good safety profile in neonates, suggesting it
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
Background:
- Bacterial infections pose a significant threat to infants.
- Limited data exists on cefoxitin's efficacy and pharmacokinetics in neonates.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of cefoxitin in treating bacterial infections in infants.
- To determine the pharmacokinetic profile of cefoxitin in this age group.
Main Methods:
- A study involving 15 infants (<2 months old) with bacterial infections.
- Intravenous cefoxitin administration (90 mg/kg/day) for 6-12 days.
- Plasma and urine cefoxitin levels measured by HPLC; pharmacokinetic analysis performed.
Main Results:
- Pathogen eradication and clinical recovery observed in 14 out of 15 patients.
- No significant adverse clinical or hematological effects attributed to cefoxitin.
- Pharmacokinetics showed a larger volume of distribution, lower clearance, and longer half-life compared to adults.
- Half-life inversely correlated with postnatal age (p<0.05).
Conclusions:
- Cefoxitin demonstrates high efficacy and a favorable safety profile for treating bacterial infections in young infants.
- Pharmacokinetic parameters in infants differ from adults, with age-dependent variations.
- Cefoxitin is a potentially safe and effective therapeutic option for susceptible bacterial infections in neonates.
Abstract:
Fifteen patients less than 2 months old with bacterial infections caused by pathogens known or presumed to be sensitive to cefoxitin were studied. Cefoxitin was administered as an i.v. bolus injection over 15 min, every 8 h for 6 to 12 days, to a total daily dosage of 90 mg/kg. In 14 patients cefoxitin therapy resulted in eradication of the pathogen and in recovery from clinical signs of infection. Only one patient did not respond to cefoxitin therapy. No adverse clinical or haematological effects definitely caused by cefoxitin were observed. Plasma and urine samples collected after the first dose were assayed for cefoxitin by HPLC. Pharmacokinetic data indicated larger apparent volume of distribution (0.5 1/kg), a smaller plasma clearance (0.27 1/h/kg) and a longer half-life (1.43 h) than in adults. The plasma half-life was inversely correlated (p less than 0.05) to the postnatal age of the patients. Cefoxitin may be safely used in infants with infections caused by susceptible pathogens.