Section of Pharmacology, Department of Neurosciences, Medical School, University of Pisa, Pisa, Italy.
Clinics (Sao Paulo). 2011;66(7):1267-74. doi: 10.1590/s1807-59322011000700024.
The aim of this work was to review the published data on the pharmacokinetics of cephalosporins in neonates to provide a critical analysis of the literature as a useful tool for physicians. The bibliographic search was performed for articles published up to December 3, 2010, using PubMed. In addition, the book Neofax: A Manual of Drugs Used in Neonatal Care by Young and Mangum was consulted. The cephalosporins are mainly eliminated by the kidneys, and their elimination rates are reduced at birth. As a consequence, clearance is reduced and t1/2 is more prolonged in the neonate than in more mature infants. The neonate's substantial body water content creates a large volume of distribution (Vd) of cephalosporins, as these drugs are fairly water soluble. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, the clearance of cephalosporins increases. The maturation of the kidney governs the pharmacokinetics of cephalosporins in the infant. Clearance and t1/2 are influenced by development, and this must be taken into consideration when planning a cephalosporin dosage regimen for the neonate.
本研究旨在回顾已发表的关于新生儿头孢菌素药代动力学的文献，为临床医生提供一个有用的文献分析工具。文献检索截止日期为 2010 年 12 月 3 日，检索工具为 PubMed。此外，还查阅了 Young 和 Mangum 所著的《新生儿护理药物实用手册》（Neofax: A Manual of Drugs Used in Neonatal Care）。头孢菌素类主要经肾脏排泄，其出生时的清除率降低。因此，与更成熟的婴儿相比，新生儿的清除率降低，半衰期延长。新生儿大量的体液使头孢菌素类药物具有较大的分布容积（Vd），因为这些药物具有较好的水溶性。出生后发育是新生儿成熟的一个重要因素，随着出生后年龄的增长，头孢菌素类的清除率增加。肾脏的成熟决定了婴儿头孢菌素类药物的药代动力学。清除率和半衰期受发育的影响，在为新生儿制定头孢菌素类药物剂量方案时必须考虑到这一点。
