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Chloramphenicol clearance in infants

G J Burckart, F F Barrett, A B Straughn

    Journal of Clinical Pharmacology
    |January 1, 1982
    PubMed
    Summary

    Evaluating chloramphenicol clearance in infants revealed significant variability. Current dosage guidelines may be excessive, necessitating serum level monitoring for safe and effective treatment.

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    Area of Science:

    • Pharmacology
    • Pediatric Medicine
    • Clinical Chemistry

    Background:

    • Chloramphenicol is an antibiotic used for severe infections.
    • Accurate dosing is crucial, especially in infants, due to potential toxicity.
    • Existing dosage guidelines require evaluation for specific patient populations.

    Purpose of the Study:

    • To evaluate chloramphenicol clearance in infants.
    • To assess the adequacy of current chloramphenicol dosage guidelines.
    • To determine the necessity of therapeutic drug monitoring.

    Main Methods:

    • A specific chemical assay was used to measure unesterified chloramphenicol.
    • Serum samples were collected from 10 infants over a 6-hour period post-infusion.
    • Chloramphenicol clearance was calculated over one dosing interval.

    Main Results:

    • Peak serum chloramphenicol concentrations varied widely (20.9–94.0 microgram/ml).
    • Clearance rates also showed significant divergence (0.058–0.236 l./kg·hr).
    • Lower concentrations were observed at 4 hours in infants receiving phenobarbital.

    Conclusions:

    • The recommended chloramphenicol dose of 100 mg/kg/day may be excessive for some infants.
    • Divergent clearance rates prevent uniform dosing, highlighting the need for individualization.
    • Serum level monitoring using a specific assay is essential for safe chloramphenicol therapy in infants.

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