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替卡西林在婴幼儿中的临床药理学及疗效

Clinical pharmacology and efficacy of ticarcillin in infants and children.

作者信息

Nelson J D, Kusmiesz H, Shelton S, Woodman E

出版信息

Pediatrics. 1978 Jun;61(6):858-63.

PMID:673548
Abstract

Ticarcillin was evaluated in 82 neonates and young infants with suspected sepsis and in 16 older children with chronic Pseudomonas infection of the mastoids. The infants also received kanamycin. Individual ticarcillin doses of 75 or 100 mg/kg were given every four, six, or eight hours by intramuscular injection or by a 30-minute intravenous infusion. Mean plasma concentrations one hour after a dose were from 125 to 189 microgram/ml, depending on dosage, age, and maturity. Mean plasma half-lives were approximately 5 hours in the first week of life, 2 hours in infants from 1 to 8 weeks, and 0.9 hours in older children. Volume of distribution was approximately twice as great in infants as in children, and plasma clearance rates correlated inversely with age. Limited efficacy data suggest that ticarcillin is a suitable alternative to ampicillin or carbenicillin, when given concurrently with an aminoglycoside, for newborn infections. When given for several days before mastoidectomy and tympanoplasty, ticarcillin sterilized the mastoids in the majority of patients. A new dosage schedule for ticarcillin in pediatric patients is proposed.

摘要

对82例疑似败血症的新生儿和幼儿以及16例患有慢性乳突假单胞菌感染的大龄儿童使用替卡西林进行了评估。这些婴儿还接受了卡那霉素治疗。替卡西林的个体剂量为75或100mg/kg,每4、6或8小时通过肌肉注射或30分钟静脉输注给药。给药后1小时的平均血浆浓度为125至189微克/毫升,具体取决于剂量、年龄和成熟度。平均血浆半衰期在出生后第一周约为5小时,1至8周的婴儿为2小时,大龄儿童为0.9小时。婴儿的分布容积约为儿童的两倍,血浆清除率与年龄呈负相关。有限的疗效数据表明,对于新生儿感染,当与氨基糖苷类药物同时使用时,替卡西林是氨苄西林或羧苄西林的合适替代品。在乳突切除术和鼓室成形术前给药数天,替卡西林使大多数患者的乳突灭菌。提出了儿科患者替卡西林的新给药方案。

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