Related Experiment Videos
Clinical pharmacology and efficacy of ticarcillin in infants and children
Insights
Ticarcillin, an antibiotic, shows promise for treating neonatal sepsis and chronic Pseudomonas infections in children. Dosing adjustments are recommended based on patient age and maturity for optimal therapeutic outcomes.
Area of Science:
- Pharmacology
- Pediatric Infectious Diseases
Background:
- Neonatal sepsis and chronic Pseudomonas infections pose significant therapeutic challenges.
- Understanding the pharmacokinetic profile of antibiotics in pediatric populations is crucial for effective treatment.
Purpose of the Study:
- To evaluate the pharmacokinetics and efficacy of ticarcillin in neonates, young infants, and older children.
- To establish an appropriate dosage regimen for ticarcillin in pediatric patients.
Main Methods:
- Ticarcillin was administered to 82 neonates/infants with suspected sepsis (with kanamycin) and 16 older children with chronic Pseudomonas mastoid infections.
- Doses of 75 or 100 mg/kg were given every 4, 6, or 8 hours via intramuscular injection or intravenous infusion.
- Plasma concentrations, half-lives, volume of distribution, and clearance rates were analyzed based on age and maturity.
Main Results:
- Mean plasma concentrations one hour post-dose ranged from 125 to 189 µg/ml.
- Mean plasma half-lives were approximately 5 hours (neonates <1 week), 2 hours (infants 1-8 weeks), and 0.9 hours (older children).
- Volume of distribution was greater in infants than children; clearance rates correlated inversely with age.
Conclusions:
- Ticarcillin, with concurrent aminoglycoside therapy, is a viable alternative to ampicillin or carbenicillin for neonatal infections.
- Ticarcillin demonstrated efficacy in sterilizing mastoid infections prior to surgery.
- A revised ticarcillin dosage schedule for pediatric patients is proposed based on these findings.
Abstract:
Ticarcillin was evaluated in 82 neonates and young infants with suspected sepsis and in 16 older children with chronic Pseudomonas infection of the mastoids. The infants also received kanamycin. Individual ticarcillin doses of 75 or 100 mg/kg were given every four, six, or eight hours by intramuscular injection or by a 30-minute intravenous infusion. Mean plasma concentrations one hour after a dose were from 125 to 189 microgram/ml, depending on dosage, age, and maturity. Mean plasma half-lives were approximately 5 hours in the first week of life, 2 hours in infants from 1 to 8 weeks, and 0.9 hours in older children. Volume of distribution was approximately twice as great in infants as in children, and plasma clearance rates correlated inversely with age. Limited efficacy data suggest that ticarcillin is a suitable alternative to ampicillin or carbenicillin, when given concurrently with an aminoglycoside, for newborn infections. When given for several days before mastoidectomy and tympanoplasty, ticarcillin sterilized the mastoids in the majority of patients. A new dosage schedule for ticarcillin in pediatric patients is proposed.