A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants

Ryochi Fujii, Shintaro Hashira, Osamu Arimasu, Kozo Fujita, Ko ichi Murono, Hiroshi Sakata, Hitoshi Kakehashi, Toshiaki Oka, Masato Kaeriyama, Hajime Yoshioka, Shizuo Maruyama, Nobutaka Sanae, Fumie Inyaku, Yoshitake Sato, Satoshi Iwata, Hiroyuki Shiro, Yutaka Kusumoto, Tadao Oikawa, Mitsuru Osano, Keisuke Sunakawa & 77 others Susumu Nakazawa, Hajime Sato, Hidejiro Chikaoka, Kenji Niino, Yoshikiyo Toyonaga, Hironori Nakamura, Morimasa Sugita, Ken ichi Kawamura, Kiwamu Seo, Makoto Hori, Naoichi Iwai, Motohiro Shibata, Fumiko Mizoguchi, Haruhi Nakamura, Michihiro Katayama, Yoichi Taneda, Kazuyo Inokuma, Tadafumi Nishimura, Toshio Takashima, Kazuo Tabuki, Tsunekazu Haruta, Kan etsu Ohkura, Shigekazu Kuroki, Hatsumi Yamamoto, Mieko Yoshioka, Yutaka Kobayashi, Takashi Motohiro, Kōichi Tanaka, Tatsuhiko Koga, Yasushi Shimada, Shobun Tomita, Yasutaka Sakata, Tamotsu Fujimoto, Naoki Kuda, Koji Ishimoto, Kaoru Tominaga, Fumio Yamashita, Nobuhiko Takajo, Nobuo Hashimoto, Takuji Fujisawa, Shohei Kinoshita, Mitsuo Nakano, Shoichi Imai, Kiyotaka Nagayama, Yushiro Yamashita, Nobuo Tanaka, Suguru Takeishi, Yutaka Ishikawa, Koji Matsumoto, Hisaaki Araki, Yoshimi Tanaka, Takeshi Yuasa, Takeo Hashimoto, Teiji Akagi, Yasunao Kuroiwa, Noboru Sato, Hisaaki Kabatake, Kimiko Hara, Toshihiro Nishimi, Kozo Sakaguchi, Fujiko Hirose, Yoshiyuki Kimura, Miwako Tsunosue, Seiichi Fukuda, Hirofumi Nakajima, Hiroshi Matsuo, Masafumi Aramaki, Junko Kajiyama, Kyoko Shibao, Mizuho Horikawa, Yuji Yamashita, Jiro Yura, Yasuhiro Kamiya, Nobuatsu Tsuruga, Takashi Hashimoto, Hiroshi Narita, Yoshimi Akamo

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. 1. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 µg/ml at 6 hours after the injection. 2. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. 3. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. 4. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. 5. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. 6. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as ‘eradicated’, 3 ‘persisted’ and 3 ‘unknown’ with eradication rate of 92.1%. Replacement of organisms (superinfection) was observed in 3 cases. 7. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT·GPT, and elevation of GOT·GPT·BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed. From the above results, the desired dosage of CAZ to neonates and premature infants should be in the unit dose of 20 mg/kg, 2 to 3 times daily to those with ages between 0 and 3 days, and 3 to 4 times daily to those with ages 4 days and above, by intravenous injection or intravenous drip infusion, with the maximum daily dose of 150 mg/kg, depending on symptoms.

Original languageEnglish
Pages (from-to)2048-2067
Number of pages20
JournalThe Japanese Journal of Antibiotics
Volume39
Issue number8
DOIs
Publication statusPublished - 1986

Fingerprint

Ceftazidime
Premature Infants
Pharmacokinetics
Newborn Infant
Intravenous Infusions
Infection
Intravenous Injections
Half-Life
Superinfection
Exanthema
Serum
Meningitis
Bilirubin
Eosinophils
Urinary Tract Infections
Diarrhea
Sepsis
Pneumonia
Blood Platelets
Injections

ASJC Scopus subject areas

  • Medicine(all)
  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Fujii, R., Hashira, S., Arimasu, O., Fujita, K., Murono, K. I., Sakata, H., ... Akamo, Y. (1986). A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. The Japanese Journal of Antibiotics, 39(8), 2048-2067. https://doi.org/10.11553/antibiotics1968b.39.2048

A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. / Fujii, Ryochi; Hashira, Shintaro; Arimasu, Osamu; Fujita, Kozo; Murono, Ko ichi; Sakata, Hiroshi; Kakehashi, Hitoshi; Oka, Toshiaki; Kaeriyama, Masato; Yoshioka, Hajime; Maruyama, Shizuo; Sanae, Nobutaka; Inyaku, Fumie; Sato, Yoshitake; Iwata, Satoshi; Shiro, Hiroyuki; Kusumoto, Yutaka; Oikawa, Tadao; Osano, Mitsuru; Sunakawa, Keisuke; Nakazawa, Susumu; Sato, Hajime; Chikaoka, Hidejiro; Niino, Kenji; Toyonaga, Yoshikiyo; Nakamura, Hironori; Sugita, Morimasa; Kawamura, Ken ichi; Seo, Kiwamu; Hori, Makoto; Iwai, Naoichi; Shibata, Motohiro; Mizoguchi, Fumiko; Nakamura, Haruhi; Katayama, Michihiro; Taneda, Yoichi; Inokuma, Kazuyo; Nishimura, Tadafumi; Takashima, Toshio; Tabuki, Kazuo; Haruta, Tsunekazu; Ohkura, Kan etsu; Kuroki, Shigekazu; Yamamoto, Hatsumi; Yoshioka, Mieko; Kobayashi, Yutaka; Motohiro, Takashi; Tanaka, Kōichi; Koga, Tatsuhiko; Shimada, Yasushi; Tomita, Shobun; Sakata, Yasutaka; Fujimoto, Tamotsu; Kuda, Naoki; Ishimoto, Koji; Tominaga, Kaoru; Yamashita, Fumio; Takajo, Nobuhiko; Hashimoto, Nobuo; Fujisawa, Takuji; Kinoshita, Shohei; Nakano, Mitsuo; Imai, Shoichi; Nagayama, Kiyotaka; Yamashita, Yushiro; Tanaka, Nobuo; Takeishi, Suguru; Ishikawa, Yutaka; Matsumoto, Koji; Araki, Hisaaki; Tanaka, Yoshimi; Yuasa, Takeshi; Hashimoto, Takeo; Akagi, Teiji; Kuroiwa, Yasunao; Sato, Noboru; Kabatake, Hisaaki; Hara, Kimiko; Nishimi, Toshihiro; Sakaguchi, Kozo; Hirose, Fujiko; Kimura, Yoshiyuki; Tsunosue, Miwako; Fukuda, Seiichi; Nakajima, Hirofumi; Matsuo, Hiroshi; Aramaki, Masafumi; Kajiyama, Junko; Shibao, Kyoko; Horikawa, Mizuho; Yamashita, Yuji; Yura, Jiro; Kamiya, Yasuhiro; Tsuruga, Nobuatsu; Hashimoto, Takashi; Narita, Hiroshi; Akamo, Yoshimi.

In: The Japanese Journal of Antibiotics, Vol. 39, No. 8, 1986, p. 2048-2067.

Research output: Contribution to journalArticle

Fujii, R, Hashira, S, Arimasu, O, Fujita, K, Murono, KI, Sakata, H, Kakehashi, H, Oka, T, Kaeriyama, M, Yoshioka, H, Maruyama, S, Sanae, N, Inyaku, F, Sato, Y, Iwata, S, Shiro, H, Kusumoto, Y, Oikawa, T, Osano, M, Sunakawa, K, Nakazawa, S, Sato, H, Chikaoka, H, Niino, K, Toyonaga, Y, Nakamura, H, Sugita, M, Kawamura, KI, Seo, K, Hori, M, Iwai, N, Shibata, M, Mizoguchi, F, Nakamura, H, Katayama, M, Taneda, Y, Inokuma, K, Nishimura, T, Takashima, T, Tabuki, K, Haruta, T, Ohkura, KE, Kuroki, S, Yamamoto, H, Yoshioka, M, Kobayashi, Y, Motohiro, T, Tanaka, K, Koga, T, Shimada, Y, Tomita, S, Sakata, Y, Fujimoto, T, Kuda, N, Ishimoto, K, Tominaga, K, Yamashita, F, Takajo, N, Hashimoto, N, Fujisawa, T, Kinoshita, S, Nakano, M, Imai, S, Nagayama, K, Yamashita, Y, Tanaka, N, Takeishi, S, Ishikawa, Y, Matsumoto, K, Araki, H, Tanaka, Y, Yuasa, T, Hashimoto, T, Akagi, T, Kuroiwa, Y, Sato, N, Kabatake, H, Hara, K, Nishimi, T, Sakaguchi, K, Hirose, F, Kimura, Y, Tsunosue, M, Fukuda, S, Nakajima, H, Matsuo, H, Aramaki, M, Kajiyama, J, Shibao, K, Horikawa, M, Yamashita, Y, Yura, J, Kamiya, Y, Tsuruga, N, Hashimoto, T, Narita, H & Akamo, Y 1986, 'A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants', The Japanese Journal of Antibiotics, vol. 39, no. 8, pp. 2048-2067. https://doi.org/10.11553/antibiotics1968b.39.2048
Fujii, Ryochi ; Hashira, Shintaro ; Arimasu, Osamu ; Fujita, Kozo ; Murono, Ko ichi ; Sakata, Hiroshi ; Kakehashi, Hitoshi ; Oka, Toshiaki ; Kaeriyama, Masato ; Yoshioka, Hajime ; Maruyama, Shizuo ; Sanae, Nobutaka ; Inyaku, Fumie ; Sato, Yoshitake ; Iwata, Satoshi ; Shiro, Hiroyuki ; Kusumoto, Yutaka ; Oikawa, Tadao ; Osano, Mitsuru ; Sunakawa, Keisuke ; Nakazawa, Susumu ; Sato, Hajime ; Chikaoka, Hidejiro ; Niino, Kenji ; Toyonaga, Yoshikiyo ; Nakamura, Hironori ; Sugita, Morimasa ; Kawamura, Ken ichi ; Seo, Kiwamu ; Hori, Makoto ; Iwai, Naoichi ; Shibata, Motohiro ; Mizoguchi, Fumiko ; Nakamura, Haruhi ; Katayama, Michihiro ; Taneda, Yoichi ; Inokuma, Kazuyo ; Nishimura, Tadafumi ; Takashima, Toshio ; Tabuki, Kazuo ; Haruta, Tsunekazu ; Ohkura, Kan etsu ; Kuroki, Shigekazu ; Yamamoto, Hatsumi ; Yoshioka, Mieko ; Kobayashi, Yutaka ; Motohiro, Takashi ; Tanaka, Kōichi ; Koga, Tatsuhiko ; Shimada, Yasushi ; Tomita, Shobun ; Sakata, Yasutaka ; Fujimoto, Tamotsu ; Kuda, Naoki ; Ishimoto, Koji ; Tominaga, Kaoru ; Yamashita, Fumio ; Takajo, Nobuhiko ; Hashimoto, Nobuo ; Fujisawa, Takuji ; Kinoshita, Shohei ; Nakano, Mitsuo ; Imai, Shoichi ; Nagayama, Kiyotaka ; Yamashita, Yushiro ; Tanaka, Nobuo ; Takeishi, Suguru ; Ishikawa, Yutaka ; Matsumoto, Koji ; Araki, Hisaaki ; Tanaka, Yoshimi ; Yuasa, Takeshi ; Hashimoto, Takeo ; Akagi, Teiji ; Kuroiwa, Yasunao ; Sato, Noboru ; Kabatake, Hisaaki ; Hara, Kimiko ; Nishimi, Toshihiro ; Sakaguchi, Kozo ; Hirose, Fujiko ; Kimura, Yoshiyuki ; Tsunosue, Miwako ; Fukuda, Seiichi ; Nakajima, Hirofumi ; Matsuo, Hiroshi ; Aramaki, Masafumi ; Kajiyama, Junko ; Shibao, Kyoko ; Horikawa, Mizuho ; Yamashita, Yuji ; Yura, Jiro ; Kamiya, Yasuhiro ; Tsuruga, Nobuatsu ; Hashimoto, Takashi ; Narita, Hiroshi ; Akamo, Yoshimi. / A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. In: The Japanese Journal of Antibiotics. 1986 ; Vol. 39, No. 8. pp. 2048-2067.
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abstract = "Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. 1. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 µg/ml at 6 hours after the injection. 2. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. 3. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. 4. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. 5. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6{\%}. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1{\%}. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9{\%} in 156 cases. 6. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as ‘eradicated’, 3 ‘persisted’ and 3 ‘unknown’ with eradication rate of 92.1{\%}. Replacement of organisms (superinfection) was observed in 3 cases. 7. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2{\%}), i.e., 3 cases of diarrhea (1.7{\%}) and 1 case of rash (0.6{\%}), and abnormal laboratory findings were observed in a total of 14 cases (7.8{\%}), i.e., increase in eosinophiles count in 8 (4.5{\%}), elevation of GOT in 3 (1.7{\%}), increase in platelet, elevation of GOT·GPT, and elevation of GOT·GPT·BUN in 1 case each (0.6{\%}). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed. From the above results, the desired dosage of CAZ to neonates and premature infants should be in the unit dose of 20 mg/kg, 2 to 3 times daily to those with ages between 0 and 3 days, and 3 to 4 times daily to those with ages 4 days and above, by intravenous injection or intravenous drip infusion, with the maximum daily dose of 150 mg/kg, depending on symptoms.",
author = "Ryochi Fujii and Shintaro Hashira and Osamu Arimasu and Kozo Fujita and Murono, {Ko ichi} and Hiroshi Sakata and Hitoshi Kakehashi and Toshiaki Oka and Masato Kaeriyama and Hajime Yoshioka and Shizuo Maruyama and Nobutaka Sanae and Fumie Inyaku and Yoshitake Sato and Satoshi Iwata and Hiroyuki Shiro and Yutaka Kusumoto and Tadao Oikawa and Mitsuru Osano and Keisuke Sunakawa and Susumu Nakazawa and Hajime Sato and Hidejiro Chikaoka and Kenji Niino and Yoshikiyo Toyonaga and Hironori Nakamura and Morimasa Sugita and Kawamura, {Ken ichi} and Kiwamu Seo and Makoto Hori and Naoichi Iwai and Motohiro Shibata and Fumiko Mizoguchi and Haruhi Nakamura and Michihiro Katayama and Yoichi Taneda and Kazuyo Inokuma and Tadafumi Nishimura and Toshio Takashima and Kazuo Tabuki and Tsunekazu Haruta and Ohkura, {Kan etsu} and Shigekazu Kuroki and Hatsumi Yamamoto and Mieko Yoshioka and Yutaka Kobayashi and Takashi Motohiro and Kōichi Tanaka and Tatsuhiko Koga and Yasushi Shimada and Shobun Tomita and Yasutaka Sakata and Tamotsu Fujimoto and Naoki Kuda and Koji Ishimoto and Kaoru Tominaga and Fumio Yamashita and Nobuhiko Takajo and Nobuo Hashimoto and Takuji Fujisawa and Shohei Kinoshita and Mitsuo Nakano and Shoichi Imai and Kiyotaka Nagayama and Yushiro Yamashita and Nobuo Tanaka and Suguru Takeishi and Yutaka Ishikawa and Koji Matsumoto and Hisaaki Araki and Yoshimi Tanaka and Takeshi Yuasa and Takeo Hashimoto and Teiji Akagi and Yasunao Kuroiwa and Noboru Sato and Hisaaki Kabatake and Kimiko Hara and Toshihiro Nishimi and Kozo Sakaguchi and Fujiko Hirose and Yoshiyuki Kimura and Miwako Tsunosue and Seiichi Fukuda and Hirofumi Nakajima and Hiroshi Matsuo and Masafumi Aramaki and Junko Kajiyama and Kyoko Shibao and Mizuho Horikawa and Yuji Yamashita and Jiro Yura and Yasuhiro Kamiya and Nobuatsu Tsuruga and Takashi Hashimoto and Hiroshi Narita and Yoshimi Akamo",
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TY - JOUR

T1 - A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants

AU - Fujii, Ryochi

AU - Hashira, Shintaro

AU - Arimasu, Osamu

AU - Fujita, Kozo

AU - Murono, Ko ichi

AU - Sakata, Hiroshi

AU - Kakehashi, Hitoshi

AU - Oka, Toshiaki

AU - Kaeriyama, Masato

AU - Yoshioka, Hajime

AU - Maruyama, Shizuo

AU - Sanae, Nobutaka

AU - Inyaku, Fumie

AU - Sato, Yoshitake

AU - Iwata, Satoshi

AU - Shiro, Hiroyuki

AU - Kusumoto, Yutaka

AU - Oikawa, Tadao

AU - Osano, Mitsuru

AU - Sunakawa, Keisuke

AU - Nakazawa, Susumu

AU - Sato, Hajime

AU - Chikaoka, Hidejiro

AU - Niino, Kenji

AU - Toyonaga, Yoshikiyo

AU - Nakamura, Hironori

AU - Sugita, Morimasa

AU - Kawamura, Ken ichi

AU - Seo, Kiwamu

AU - Hori, Makoto

AU - Iwai, Naoichi

AU - Shibata, Motohiro

AU - Mizoguchi, Fumiko

AU - Nakamura, Haruhi

AU - Katayama, Michihiro

AU - Taneda, Yoichi

AU - Inokuma, Kazuyo

AU - Nishimura, Tadafumi

AU - Takashima, Toshio

AU - Tabuki, Kazuo

AU - Haruta, Tsunekazu

AU - Ohkura, Kan etsu

AU - Kuroki, Shigekazu

AU - Yamamoto, Hatsumi

AU - Yoshioka, Mieko

AU - Kobayashi, Yutaka

AU - Motohiro, Takashi

AU - Tanaka, Kōichi

AU - Koga, Tatsuhiko

AU - Shimada, Yasushi

AU - Tomita, Shobun

AU - Sakata, Yasutaka

AU - Fujimoto, Tamotsu

AU - Kuda, Naoki

AU - Ishimoto, Koji

AU - Tominaga, Kaoru

AU - Yamashita, Fumio

AU - Takajo, Nobuhiko

AU - Hashimoto, Nobuo

AU - Fujisawa, Takuji

AU - Kinoshita, Shohei

AU - Nakano, Mitsuo

AU - Imai, Shoichi

AU - Nagayama, Kiyotaka

AU - Yamashita, Yushiro

AU - Tanaka, Nobuo

AU - Takeishi, Suguru

AU - Ishikawa, Yutaka

AU - Matsumoto, Koji

AU - Araki, Hisaaki

AU - Tanaka, Yoshimi

AU - Yuasa, Takeshi

AU - Hashimoto, Takeo

AU - Akagi, Teiji

AU - Kuroiwa, Yasunao

AU - Sato, Noboru

AU - Kabatake, Hisaaki

AU - Hara, Kimiko

AU - Nishimi, Toshihiro

AU - Sakaguchi, Kozo

AU - Hirose, Fujiko

AU - Kimura, Yoshiyuki

AU - Tsunosue, Miwako

AU - Fukuda, Seiichi

AU - Nakajima, Hirofumi

AU - Matsuo, Hiroshi

AU - Aramaki, Masafumi

AU - Kajiyama, Junko

AU - Shibao, Kyoko

AU - Horikawa, Mizuho

AU - Yamashita, Yuji

AU - Yura, Jiro

AU - Kamiya, Yasuhiro

AU - Tsuruga, Nobuatsu

AU - Hashimoto, Takashi

AU - Narita, Hiroshi

AU - Akamo, Yoshimi

PY - 1986

Y1 - 1986

N2 - Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. 1. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 µg/ml at 6 hours after the injection. 2. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. 3. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. 4. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. 5. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. 6. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as ‘eradicated’, 3 ‘persisted’ and 3 ‘unknown’ with eradication rate of 92.1%. Replacement of organisms (superinfection) was observed in 3 cases. 7. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT·GPT, and elevation of GOT·GPT·BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed. From the above results, the desired dosage of CAZ to neonates and premature infants should be in the unit dose of 20 mg/kg, 2 to 3 times daily to those with ages between 0 and 3 days, and 3 to 4 times daily to those with ages 4 days and above, by intravenous injection or intravenous drip infusion, with the maximum daily dose of 150 mg/kg, depending on symptoms.

AB - Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. 1. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 µg/ml at 6 hours after the injection. 2. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. 3. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. 4. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. 5. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. 6. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as ‘eradicated’, 3 ‘persisted’ and 3 ‘unknown’ with eradication rate of 92.1%. Replacement of organisms (superinfection) was observed in 3 cases. 7. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT·GPT, and elevation of GOT·GPT·BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed. From the above results, the desired dosage of CAZ to neonates and premature infants should be in the unit dose of 20 mg/kg, 2 to 3 times daily to those with ages between 0 and 3 days, and 3 to 4 times daily to those with ages 4 days and above, by intravenous injection or intravenous drip infusion, with the maximum daily dose of 150 mg/kg, depending on symptoms.

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U2 - 10.11553/antibiotics1968b.39.2048

DO - 10.11553/antibiotics1968b.39.2048

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SP - 2048

EP - 2067

JO - The Journal of antibiotics. Ser. B

JF - The Journal of antibiotics. Ser. B

SN - 0368-2781

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