Okura K E, Yamaoka K, Kuroki S, Yamamoto H, Haruta T, Kobayashi Y
Department of Pediatrics, Kobe Central Municipal Hospital.
Jpn J Antibiot. 1988 Aug;41(8):1106-15.
Ceftizoxime (CZX) was evaluated for absorption and excretion as well as for therapeutic effectiveness in neonates and premature infants. The following results were obtained. 1. Serum CZX concentrations were determined in 8 neonates or premature infants who were not more than 6 days old. Serum concentrations of the drug were examined in 6 neonates and/or premature infants after intravenous administration of about 20 mg/kg body weight. Average concentration at 1/2, 2, 4 and 6 hours after administration were 52.3, 36.4, 26.7 and 16.7 micrograms/ml, respectively. Serum concentrations in the other 2 infants who were given 29.7 and 25.1 mg/kg, were as high as 71 and 94 micrograms/ml at 1/2 hour and 22.1 and 39 micrograms/ml at 6 hours, respectively. Serum half-lives in 5 of the 6 mature neonates ranged from 2.36 to 3.34 hours, with averaged 2.75 hours, but was exceptionally long, 7.92 hours, in the other one. Half-lives in the 2 premature infants were 4.14 and 4.90 hours. 2. The therapeutic effectiveness on bacterial infection was evaluated for 10 newborn infants. Intravenous doses of 16.9 to 24.6 mg/kg were given in b.i.d. or t.i.d. regimen to 4 cases with pneumonia and 2 with septicemia, urinary tract infection and fetal infection each. To 1 infant with septicemia complicated with cephalohematoma, higher doses ranged from 21.8 to 49.8 mg/kg were given t.i.d. or q.i.d. Therapeutic efficacies were assessed as "Excellent" in 3, "Good" in 6, and "Poor" in 1, with an efficacy rate of 90.0%. Eradication of bacteria was complete in 2 infants each with Escherichia coli-induced septicemia or urinary tract infection. 3. For prophylactic use, the drug was given to 8 newborn infants in intravenous doses of 17.5 to 29.1 mg/kg b.i.d. or t.i.d. and no infection occurred in 7 cases. 4. No adverse reactions were obtained. Slight and transient increases in platelet count, GOT and GPT in 1 case and eosinophilia in another were observed. 5. These results suggested that CZX in an intravenous dose of 20 mg/kg b.i.d. or t.i.d. regimen in newborn infants up to 7 days of age would be effective and safe for the treatment of neonatal bacterial infections.
对头孢唑肟（CZX）在新生儿和早产儿中的吸收、排泄以及治疗效果进行了评估。获得了以下结果。1. 对8名年龄不超过6天的新生儿或早产儿测定了血清CZX浓度。对6名新生儿和/或早产儿静脉注射约20mg/kg体重的药物后检测了药物的血清浓度。给药后1/2、2、4和6小时的平均浓度分别为52.3、36.4、26.7和16.7μg/ml。另外两名分别给予29.7mg/kg和25.1mg/kg的婴儿，1/2小时时血清浓度分别高达71和94μg/ml，6小时时分别为22.1和39μg/ml。6名成熟新生儿中有5名的血清半衰期为2.36至3.34小时，平均为2.75小时，但另一名的半衰期异常长，为7.92小时。2名早产儿的半衰期分别为4.14和4.90小时。2. 对10名新生儿的细菌感染治疗效果进行了评估。对4例肺炎、2例败血症、尿路感染和胎儿感染的患儿，采用每日两次或三次的给药方案，静脉注射剂量为16.9至24.6mg/kg。对1例合并头颅血肿的败血症患儿，采用每日三次或四次的给药方案，给予更高剂量，范围为21.8至49.8mg/kg。治疗效果评估为“优”的有3例，“良”的有6例，“差”的有1例，有效率为90.0%。2例大肠杆菌引起的败血症或尿路感染患儿的细菌被彻底清除。3. 预防性使用时，对8名新生儿静脉注射剂量为17.5至29.1mg/kg，每日两次或三次，7例未发生感染。4. 未观察到不良反应。观察到1例血小板计数、谷草转氨酶和谷丙转氨酶轻度短暂升高，另1例嗜酸性粒细胞增多。5. 这些结果表明，对于7日龄以内的新生儿，静脉注射剂量为20mg/kg，每日两次或三次的CZX对治疗新生儿细菌感染有效且安全。
