Amoxicillin in paediatrics, with special reference to its excretion into bronchial secretion
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Abstract:
Pharmacokinetic examinations with amoxicillin in neonates and prematures are reported. Good values of up to 5 mcg/ml after 24 hours were achieved with two doses of 50 mg/kg amoxicillin daily. Amoxicillin was also found in the meconium, although quantities varied greatly. Amoxicillin is recommended for the treatment of disorders of the respiratory tract because of its good absorption, tissue penetration and tolerance. Examinations to assess the excretion of amoxicillin into the bronchial secretion were therefore carried out in 88 children in different age groups. Two artificial respiration bronchoscopies were carried out with an interval of 7 days, and the bronchial secretion collected and tested for organisms and for amoxicillin concentrations. After the first bronchoscopy, patients were given amoxicillin for 7 days, in doses of 125 to 750 mg t.i.d., corresponding to 40-100 mg/kg body weight. Some very high amoxicillin values were found, especially in those groups from whom the secretion was taken 2, 3, or 4 hours after the last amoxicillin treatment. The values were widely scattered. We recommended 50-100 mg/kg for broncho-pulmonary diseases.
Insights
Pharmacokinetic studies show amoxicillin achieves good levels in neonates and prematures. Recommended dosages for broncho-pulmonary diseases ensure effective amoxicillin concentrations in bronchial secretions.
Area of Science:
- Pediatric Pharmacology
- Respiratory Medicine
- Antibiotic Pharmacokinetics
Background:
- Amoxicillin is frequently used for respiratory tract infections due to its favorable absorption, tissue penetration, and tolerance.
- Limited pharmacokinetic data exists for amoxicillin in neonates and premature infants, necessitating further investigation.
Purpose of the Study:
- To evaluate amoxicillin pharmacokinetics in neonates and premature infants.
- To assess amoxicillin concentrations in bronchial secretions of pediatric patients with broncho-pulmonary diseases.
Main Methods:
- Pharmacokinetic analysis of amoxicillin in neonates and prematures.
- Collection and analysis of bronchial secretions via bronchoscopy in 88 children across different age groups.
- Measurement of amoxicillin concentrations in bronchial secretions at various time points post-administration.
Main Results:
- Amoxicillin achieved concentrations up to 5 mcg/ml in neonates with 50 mg/kg daily doses.
- Amoxicillin was detected in meconium, with variable quantities.
- Significant amoxicillin levels were found in bronchial secretions, particularly 2-4 hours after the last dose, though values were widely scattered.
Conclusions:
- Amoxicillin demonstrates good pharmacokinetic properties in neonates and prematures.
- Recommended dosages of 50-100 mg/kg are suggested for treating broncho-pulmonary diseases in children to achieve adequate bronchial secretion levels.