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Absorption of erythromycin from pediatric suspension in infants and children
Insights
Erythromycin absorption varies in infants, with lower levels in newborns. Erythromycin ethylsuccinate showed better absorption, especially with food, and no liver toxicity in infants.
Area of Science:
- Pediatric Pharmacology
- Drug Absorption and Metabolism
- Infectious Disease Treatment
Background:
- Erythromycin is a commonly prescribed antibiotic for infants and children.
- Understanding erythromycin absorption is crucial for effective pediatric dosing.
- Different erythromycin formulations (ethylsuccinate, stearate) may have varying pharmacokinetic profiles.
Purpose of the Study:
- To estimate the absorption of erythromycin suspensions in infants and children.
- To compare the absorption of erythromycin ethylsuccinate and erythromycin stearate across different age groups.
- To evaluate the effect of food intake on the absorption of different erythromycin formulations.
Main Methods:
- Study population divided into three age groups: 0-1 month, 1-6 months, and 6 months-6 years.
- Administration of erythromycin suspension (ethylsuccinate and stearate forms).
- Absorption levels assessed in both fasting and fed states.
Main Results:
- Erythromycin absorption was significantly lower in infants aged 0-1 month compared to older children.
- Erythromycin ethylsuccinate and stearate showed similar absorption in fasting older children (6 months-6 years).
- Food intake increased erythromycin ethylsuccinate absorption but had minimal effect on erythromycin stearate absorption.
- Erythromycin stearate absorption was lower than ethylsuccinate in fasting infants (1-6 months).
- No liver toxicity or whooping cough symptoms observed in infants treated with erythromycin ethylsuccinate.
Conclusions:
- Age significantly influences erythromycin absorption in pediatric populations, with neonates exhibiting lower absorption.
- Erythromycin ethylsuccinate demonstrates superior absorption, particularly when administered with meals, compared to erythromycin stearate.
- Erythromycin ethylsuccinate appears safe and effective for treating conditions like whooping cough in infants, with no observed hepatotoxicity.
Abstract:
The absorption of erythromycin in infants and children was estimated after the administration of an erythromycin suspension. The subjects were divided into 3 age groups: 0-1 month, 1-6 months and 6 months-6 years. The absorption was lower in infants less than 1 month of age than in the older children. Erythromycin ethylsuccinate and erythromycin stearate were equally well absorbed in the fasting state in subjects 6 months-6 years of age. Administration of the drug at mealtimes considerably increased the absorption of erythromycin ethylsuccinate but had little effect on the absorption of erythromycin stearate. The absorption of erythromycin stearate in the fasting state was much lower than that of erythromycin ethylsuccinate in infants 1-6 months of age. None of the infants given erythromycin ethylsuccinate because of an outbreak of whooping-cough on the neonatal ward showed evidence of liver toxicity, nor did they develop symptoms of whooping-cough.