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Pharmacology of trimethoprim-sulfamethoxazole in newborn infants
Insights
This study determined the pharmacokinetics of sulfamethoxazole (SMZ) and trimethoprim (TMP) in newborn infants. Recommended doses were established, showing no adverse effects or impact on bilirubin binding.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Clinical Pharmacy
Background:
- Sulfamethoxazole and trimethoprim are commonly used antibiotics.
- Understanding their pharmacokinetic profiles in newborns is crucial for safe and effective dosing.
Purpose of the Study:
- To determine the pharmacokinetic parameters of sulfamethoxazole and trimethoprim in newborn infants.
- To establish appropriate loading and maintenance doses for these antibiotics in neonates.
- To assess the safety of sulfamethoxazole and trimethoprim regarding adverse effects and bilirubin binding.
Main Methods:
- Pharmacokinetic analysis of sulfamethoxazole and trimethoprim in 12 neonates (<3 days postnatal age).
- Intravenous administration (single or repeated).
- Measurement of half-life, volume of distribution, and clearance.
Main Results:
- Mean half-lives: SMZ 16.5 hours, TMP 19.0 hours.
- Mean volumes of distribution: SMZ 0.48 L/kg, TMP 2.7 L/kg.
- Mean clearances: SMZ 0.65 ml/minute, TMP 3.31 ml/minute.
Conclusions:
- Recommended loading dose: SMZ 10 mg/kg, TMP 3 mg/kg.
- Recommended maintenance dose: SMZ 3 mg/kg, TMP 1 mg/kg twice daily.
- No adverse effects or changes in albumin's bilirubin-binding capacity were observed at therapeutic concentrations.
Abstract:
The pharmacokinetic parameters of sulfamethoxazole and trimethoprim were measured in 12 newborn infants of less than 3 days postnatal age, following a single or repeated intravenous injection. The mean half-lives for SMZ and TMP were 16.5 hours and 19.0 hours, respectively. The mean volumes of distribution were SMZ 0.48 L/kg and TMP 2.7 L/kg. The mean drug clearances were SMZ 0.65 ml/minute and TMP 3.31 ml/minute. From these data the recommended loading dose is SMZ 10 mg/kg with TMP 3 mg/kg, and the maintenance dose is SMZ 3 mg/kg with TMP 1 mg/kg twice daily. No adverse side effects were seen during treatment, and the bilirubin-binding capacity of albumin were not changed at therapeutic concentrations of the antimicrobial drugs.