Low D C, Bissenden J G, Wise R
Arch Dis Child. 1985 Apr;60(4):360-4. doi: 10.1136/adc.60.4.360.
Ninety one neonates received 108 courses of intravenous ceftazidime (25 mg/kg, 12 hourly) over a study period of 15 months. Fourteen had clinically and bacteriologically proved infections. Only one of these had resistant organisms. Four (two with group B beta haemolytic streptococcal infections, one with Escherichia coli meningitis, and one with Staphylococcal aureus septicaemia) failed to respond despite adequate treatment. Bacteriological eradication or clinical improvement, or both, were obtained in the remaining nine. Routine biochemical and haematological values were monitored and there were no side effects. High serum ceftazidime concentrations, well exceeding the minimum inhibitory concentration for most common neonatal pathogens were obtained and maintained throughout treatment. Penetration into the cerebrospinal fluid was excellent in eight of the nine cases studied. Ceftazidime has a theoretical role as a broad spectrum antibiotic suitable for neonatal use with no evident side effects. In this study, however, it was only appropriate for Gram negative infections, and was ineffective against Gram positive organisms. Ceftazidime cannot therefore be recommended as monotherapy before the results of bacteriological culture are known.
在15个月的研究期间，91名新生儿接受了108个疗程的静脉注射头孢他啶（25毫克/千克，每12小时一次）。14名新生儿有临床和细菌学证实的感染。其中只有1名有耐药菌。尽管进行了充分治疗，但仍有4名（2名患有B组β溶血性链球菌感染，1名患有大肠杆菌脑膜炎，1名患有金黄色葡萄球菌败血症）没有反应。其余9名实现了细菌学清除或临床改善，或两者兼有。监测了常规生化和血液学指标，未发现副作用。在整个治疗过程中，均获得并维持了高血清头孢他啶浓度，该浓度远超过大多数常见新生儿病原体的最低抑菌浓度。在所研究的9例病例中，有8例脑脊液中的药物渗透率极佳。头孢他啶作为一种适合新生儿使用的广谱抗生素，理论上具有一定作用且无明显副作用。然而，在本研究中，它仅适用于革兰氏阴性菌感染，对革兰氏阳性菌无效。因此，在细菌培养结果出来之前，不能推荐将头孢他啶作为单一疗法。
