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新生儿头孢曲松的药代动力学与临床评估

[Pharmacokinetic and clinical evaluations on ceftriaxone in neonates].

作者信息

Iwai N, Nakamura H, Miyazu M, Katayama M, Taneda Y

机构信息

Department of Pediatrics, Meitetsu Hospital.

出版信息

Jpn J Antibiot. 1988 Mar;41(3):262-75.

PMID:3404646
Abstract
  1. Ten neonates 0 to 28 days old (gestation: 37-42 weeks; birth weight: 2,160-3,640 g) received 20 mg/kg CTRX (8 cases) or 10 mg/kg (2 cases) by intravenous bolus injection, while 9 infants 35 days to 9 months old (gestation: 37-43 weeks; birth weight: 2,800-3,560 g) received 20 mg/kg by intravenous bolus injection, and their blood drug concentrations and urinary drug excretions were examined. Average blood levels of CTRX in the 20 mg/kg dosage group were 114 +/- 14.6 micrograms/ml at 30 minutes, 109 +/- 12.8 micrograms/ml at 1 hour, 100 +/- 12.6 micrograms/ml at 2 hours, 87.9 +/- 15.8 micrograms/ml at 4 hours, 72.8 +/- 15.3 micrograms/ml at 6 hours, and 50.1 +/- 12.3 micrograms/ml at 12 hours in the neonates; and 113 +/- 20.0 micrograms/ml at 30 minutes, 101 +/- 14.7 micrograms/ml at 1 hour, 83.6 +/- 9.3 micrograms/ml at 2 hours, 70.3 +/- 10.7 micrograms/ml at 4 hours, 56.9 +/- 8.6 micrograms/ml at 6 hours, and 35.7 +/- 9.2 micrograms/ml at 12 hours in the infants. Average half-lives of CTRX in blood were 10.3 +/- 4.5 hours in the neonates, and 6.6 +/- 1.9 hours in the infants. Average blood concentrations of CTRX in the 10 mg/kg dosage neonate group were 63.8 +/- 6.0 micrograms/ml at 30 minutes, 57.8 +/- 2.5 micrograms/ml at 1 hour, 53.5 +/- 0.7 micrograms/ml at 2 hours, 41.8 +/- 7.4 micrograms/ml at 4 hours, 32.4 +/- 5.9 micrograms/ml at 6 hours, and 20.8 +/- 1.1 micrograms/ml at 12 hours, and the half-life was 7.2 +/- 0.4 hours. These results suggest that blood concentrations are apparently dose-related in the neonate period; that the peak levels of the neonate and infant groups were similar (the levels at 30 minutes) not showing a relationship to age, gestation period or to birth weight; and that the higher the age was the shorter the half-life became with the half-life in the one week old group was 1.5 times as long as that in the older infant group. The half-life in the younger infant group, however, was similar to that in the older infant group. Urinary excretion was examined in 4 neonates and 2 infants. Average urinary recovery rates in 12 hours after intravenous injection were 40.8 +/- 8.3% in the neonate group and 44.8 +/- 12.8% in the infant group, showing that CTRX is excreted well even in the neonate period.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 10名0至28日龄的新生儿(胎龄:37 - 42周;出生体重:2160 - 3640克)通过静脉推注接受20毫克/千克的头孢曲松(CTRX)(8例)或10毫克/千克(2例),而9名35日龄至9个月龄的婴儿(胎龄:37 - 43周;出生体重:2800 - 3560克)通过静脉推注接受20毫克/千克,检测了他们的血药浓度和尿药排泄情况。20毫克/千克剂量组新生儿在30分钟时CTRX的平均血药浓度为114±14.6微克/毫升,1小时时为109±12.8微克/毫升,2小时时为100±12.6微克/毫升,4小时时为87.9±15.8微克/毫升,6小时时为72.8±15.3微克/毫升,12小时时为50.1±12.3微克/毫升;婴儿在30分钟时为113±20.0微克/毫升,1小时时为101±14.7微克/毫升,2小时时为83.6±9.3微克/毫升,4小时时为70.3±10.7微克/毫升,6小时时为56.9±8.6微克/毫升,12小时时为35.7±9.2微克/毫升。CTRX在新生儿血中的平均半衰期为10.3±4.5小时,在婴儿中为6.6±1.9小时。10毫克/千克剂量新生儿组在30分钟时CTRX的平均血药浓度为63.8±6.0微克/毫升,1小时时为57.8±2.5微克/毫升,2小时时为53.5±0.7微克/毫升,4小时时为41.8±7.4微克/毫升,6小时时为32.4±5.9微克/毫升,12小时时为20.8±1.1微克/毫升,半衰期为7.2±0.4小时。这些结果表明,在新生儿期血药浓度明显与剂量相关;新生儿组和婴儿组的峰值水平相似(30分钟时的水平),与年龄、胎龄或出生体重无关;年龄越大半衰期越短,1周龄组的半衰期是较大婴儿组的1.5倍。然而,较小婴儿组的半衰期与较大婴儿组相似。对4名新生儿和2名婴儿进行了尿排泄检测。静脉注射后12小时内新生儿组的平均尿回收率为40.8±8.3%,婴儿组为44.8±12.8%,表明即使在新生儿期CTRX的排泄也良好。(摘要截于400字)

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