Placzek M, Whitelaw A, Want S, Sahathevan M, Darrell J
Arch Dis Child. 1983 Dec;58(12):1006-9. doi: 10.1136/adc.58.12.1006.
Seventy infants with suspected bacterial infection in the first 48 hours of life were treated either with piperacillin and flucloxacillin or with penicillin and gentamicin. Infection was confirmed and successfully eradicated in 6 of the 35 infants receiving piperacillin and flucloxacillin. Four infants treated with penicillin and gentamicin had confirmed infection and one deteriorated initially but then recovered when treated with piperacillin. Serum piperacillin concentrations above 100 mg/l and cerebrospinal fluid piperacillin concentrations of 2.6-6 mg/l were noted for up to four hours and 7 hours respectively, even in the absence of inflamed meninges, after administration of piperacillin 100 mg/kg body weight intravenously. Median half life of piperacillin was 6.5 hours and was prolonged in renal impairment. Piperacillin is considered to be a safe and effective first line single agent treatment for early neonatal infection but because some Escherichia coli are resistant to it we recommend that a second agent be used in critically ill infants with neutropenia or meningitis.
70名在出生后48小时内疑似细菌感染的婴儿，分别接受了哌拉西林和氟氯西林治疗，或青霉素和庆大霉素治疗。在接受哌拉西林和氟氯西林治疗的35名婴儿中，有6名感染得到确诊并成功根除。4名接受青霉素和庆大霉素治疗的婴儿确诊感染，其中1名最初病情恶化，但在接受哌拉西林治疗后康复。静脉注射100mg/kg体重的哌拉西林后，即使在没有脑膜炎症的情况下，血清哌拉西林浓度在100mg/l以上的情况持续了4小时，脑脊液哌拉西林浓度在2.6 - 6mg/l的情况持续了7小时。哌拉西林的中位半衰期为6.5小时，在肾功能损害时会延长。哌拉西林被认为是治疗早期新生儿感染的一种安全有效的一线单药治疗药物，但由于一些大肠杆菌对其耐药，我们建议对患有中性粒细胞减少症或脑膜炎的重症婴儿使用第二种药物。
