Pharmacokinetic and clinical studies with meropenem in the pediatric field

Ryochi Fujii, Hajime Yoshioka, Kozo Fujita, Shizuo Maruyama, Hiroshi Sakata, Fumie Inyaku, Syunzo Chiba, Hiroyuki Tsutsumi, Yoshinori Wagatsuma, Naoki Fukushima, Akashi Ishikawa, Aiko Takase, Akira Watanabe, Kenji Sato, Masaru Yokoyama, Kyoichi Kawauchi, Yoshihiro Takahashi, Tadanori Okamoto, Toshiaki Abe, Tsuyoshi TajimaHaruo Ichihashi, Nobuo Watanabe, Hiroo Matsuda, Kenichi Mikuni, Susumu Nakazawa, Hajime Sato, Kenji Niinou, Keisuke Sunakawa, Takao Yokota, Yasuko Nitta, Hironobu Akita, Satoshi Iwata, Yoshitake Sato, Kei Hachimori, Masako Noda, Yoshikiyo Toyonaga, Kazuko Yamori, Kazuo Hatakeyama, Kiwamu Seo, Kenichi Kawamura, Hironori Nakamura, Shigeru Toyoda, Nobuhiko Okabe, Akira Katayama, Yoko Kato, Itaru Terashima, Hidenori Meguro, Atsuo Mori, Tomomichi Kurosaki, Tsuyoshi Toba, Akira Nakamura, Hiroo Niimi, Hiroshi Suzuki, Naoichi Iwai, Yoichi Taneda, Haruhi Nakamura, Kuniyoshi Kuno, Tadashi Nishimura, Kazuo Tabuki, Shigeyuki Aoki, Michio Takagi, Yutaka Kobayashi, Tsunekazu Haruta, Shigekazu Kuroki, Kanetsu Okura, Hiroyuki Nishi, Toshikazu Nishio, Takashi Motohiro, Hirokazu Sasaki, Masafumi Aramaki, Yasutaka Sakata, Fumio Yamashita

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Pharmacokinetic and clinical evaluations in pediatrics were made on meropenem (SM-7338, MEPM), a new parenteral dehydropeptidase-1 stable carbapenem used without any inhibitors, at 33 medical institutions. The results are summerized as follows. 1. Pharmacokinetic studies MEPM at a dose of 10, 20, or 40 mg/kg was administered to 53 children by 30-minute drip infusion. Peak plasma concentrations (Cmax's) and plasma half-lives (T 1/2's) of these doses were 28.5, 47.2 and 130.0μg/ml, and 0.80, 0.93 and 0.94 hours, respectively. A clear dose response was observed in Cmax's and T 1/2 values were quite similar to those observed in adults. In the first 6 hours after administration, 54.4 to 68.1% of the administered drug was recovered in urine. The cerebrospinal fluid (CSF) levels of MEPM in patients with purulent meningitis were 0.13 μg/ml at a dose of 6 mg/kg, and 0.64 to 4.22 μg/ml at a dose of 29 to 44 mg/kg within day 4 of onset. The penetration rate of MEPM showed an intermediate value among those for other cephalospolin antibiotics. 2. Clinical study Clinical efficacies of MEPM were evaluated in 389 cases. The most common doses used were 10 to 20 mg/kg/once, 2 to 3 times a day. The maximum dose was 173 mg/kg/day q.i.d. MEPM gave “exellent” or “good” responces in 242 (97.6%) out of 248 cases in which causative organisms were documented and in 134 (95.0%) out of 141 cases in which causative organisms were not identified. Clinical efficacy rates were 100% in 11 patients with purulent meningitis, 85.7% in 7 with septicemia, 98.8% in 173 with pneumonia, and 100% in 65 with UTI. Bacteriologically, 260 strains (96.7%) out of 269 strains were eradicated by MEPM treatment. Eradication rates were 89.2% for Staphylococcus aureus (37 strains) and 100% for Streptococcus pneumoniae (35 strains). The overall eradication rate for Gram-positive bacteria was 94.6%. Among Gram-negative bacteria, 98.3% out of 172 strains were eradicated. The eradication rate of Haemophilus influenzae (73 strains) was 98.6% and Pseudomonas aeruginosa (11 strains) was 90.9%, and all of Branhamella catarrhalis (15 strains), Escherichia coli (42 strains), and Klebsiella pneumoniae (6 strains) were eradicated. Out of 84 cases for which previous antibiotic therapies of 3 days or longer were not successful, MEPM gave “exellent” or “good” responces in 77 cases (91.7%) and exellent bacteriological responces (95.7%). 3. Side effects and laboratory test results Among 403 cases, 6 symptoms were noted as side effects in 5 cases including diarrhea, rash, watery stools and loose stools. Abnormal laboratory results occurred in 58 cases including increases in GOT, GPT, 7-GTP, LDH, LAP and eosinophil counts, and decrease in neutrophil counts. Based on these results, we concluded that the standard dose of MEPM in pediatrics would be 10 to 20 mg/kg/once, 2 to 3 times a day. The dosage may be altered according to symptoms. In conclusion, MEPM is a useful and safe drug for the treatment of various infections in children including severe infectious diseases such as purulent meningitis and septicemia.

Original languageEnglish
Pages (from-to)697-717
Number of pages21
JournalThe Japanese Journal of Antibiotics
Volume45
Issue number6
DOIs
Publication statusPublished - 1992
Externally publishedYes

Fingerprint

meropenem
Meningitis
Pharmacokinetics
Pediatrics
Sepsis
Anti-Bacterial Agents
Moraxella (Branhamella) catarrhalis
Carbapenems
Haemophilus influenzae
Klebsiella pneumoniae
Gram-Positive Bacteria
Guanosine Triphosphate
Streptococcus pneumoniae
Exanthema
Gram-Negative Bacteria
Eosinophils
Intravenous Infusions
Pharmaceutical Preparations
Pseudomonas aeruginosa
Communicable Diseases

ASJC Scopus subject areas

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

Cite this

Fujii, R., Yoshioka, H., Fujita, K., Maruyama, S., Sakata, H., Inyaku, F., ... Yamashita, F. (1992). Pharmacokinetic and clinical studies with meropenem in the pediatric field. The Japanese Journal of Antibiotics, 45(6), 697-717. https://doi.org/10.11553/antibiotics1968b.45.697

Pharmacokinetic and clinical studies with meropenem in the pediatric field. / Fujii, Ryochi; Yoshioka, Hajime; Fujita, Kozo; Maruyama, Shizuo; Sakata, Hiroshi; Inyaku, Fumie; Chiba, Syunzo; Tsutsumi, Hiroyuki; Wagatsuma, Yoshinori; Fukushima, Naoki; Ishikawa, Akashi; Takase, Aiko; Watanabe, Akira; Sato, Kenji; Yokoyama, Masaru; Kawauchi, Kyoichi; Takahashi, Yoshihiro; Okamoto, Tadanori; Abe, Toshiaki; Tajima, Tsuyoshi; Ichihashi, Haruo; Watanabe, Nobuo; Matsuda, Hiroo; Mikuni, Kenichi; Nakazawa, Susumu; Sato, Hajime; Niinou, Kenji; Sunakawa, Keisuke; Yokota, Takao; Nitta, Yasuko; Akita, Hironobu; Iwata, Satoshi; Sato, Yoshitake; Hachimori, Kei; Noda, Masako; Toyonaga, Yoshikiyo; Yamori, Kazuko; Hatakeyama, Kazuo; Seo, Kiwamu; Kawamura, Kenichi; Nakamura, Hironori; Toyoda, Shigeru; Okabe, Nobuhiko; Katayama, Akira; Kato, Yoko; Terashima, Itaru; Meguro, Hidenori; Mori, Atsuo; Kurosaki, Tomomichi; Toba, Tsuyoshi; Nakamura, Akira; Niimi, Hiroo; Suzuki, Hiroshi; Iwai, Naoichi; Taneda, Yoichi; Nakamura, Haruhi; Kuno, Kuniyoshi; Nishimura, Tadashi; Tabuki, Kazuo; Aoki, Shigeyuki; Takagi, Michio; Kobayashi, Yutaka; Haruta, Tsunekazu; Kuroki, Shigekazu; Okura, Kanetsu; Nishi, Hiroyuki; Nishio, Toshikazu; Motohiro, Takashi; Sasaki, Hirokazu; Aramaki, Masafumi; Sakata, Yasutaka; Yamashita, Fumio.

In: The Japanese Journal of Antibiotics, Vol. 45, No. 6, 1992, p. 697-717.

Research output: Contribution to journalArticle

Fujii, R, Yoshioka, H, Fujita, K, Maruyama, S, Sakata, H, Inyaku, F, Chiba, S, Tsutsumi, H, Wagatsuma, Y, Fukushima, N, Ishikawa, A, Takase, A, Watanabe, A, Sato, K, Yokoyama, M, Kawauchi, K, Takahashi, Y, Okamoto, T, Abe, T, Tajima, T, Ichihashi, H, Watanabe, N, Matsuda, H, Mikuni, K, Nakazawa, S, Sato, H, Niinou, K, Sunakawa, K, Yokota, T, Nitta, Y, Akita, H, Iwata, S, Sato, Y, Hachimori, K, Noda, M, Toyonaga, Y, Yamori, K, Hatakeyama, K, Seo, K, Kawamura, K, Nakamura, H, Toyoda, S, Okabe, N, Katayama, A, Kato, Y, Terashima, I, Meguro, H, Mori, A, Kurosaki, T, Toba, T, Nakamura, A, Niimi, H, Suzuki, H, Iwai, N, Taneda, Y, Nakamura, H, Kuno, K, Nishimura, T, Tabuki, K, Aoki, S, Takagi, M, Kobayashi, Y, Haruta, T, Kuroki, S, Okura, K, Nishi, H, Nishio, T, Motohiro, T, Sasaki, H, Aramaki, M, Sakata, Y & Yamashita, F 1992, 'Pharmacokinetic and clinical studies with meropenem in the pediatric field', The Japanese Journal of Antibiotics, vol. 45, no. 6, pp. 697-717. https://doi.org/10.11553/antibiotics1968b.45.697
Fujii, Ryochi ; Yoshioka, Hajime ; Fujita, Kozo ; Maruyama, Shizuo ; Sakata, Hiroshi ; Inyaku, Fumie ; Chiba, Syunzo ; Tsutsumi, Hiroyuki ; Wagatsuma, Yoshinori ; Fukushima, Naoki ; Ishikawa, Akashi ; Takase, Aiko ; Watanabe, Akira ; Sato, Kenji ; Yokoyama, Masaru ; Kawauchi, Kyoichi ; Takahashi, Yoshihiro ; Okamoto, Tadanori ; Abe, Toshiaki ; Tajima, Tsuyoshi ; Ichihashi, Haruo ; Watanabe, Nobuo ; Matsuda, Hiroo ; Mikuni, Kenichi ; Nakazawa, Susumu ; Sato, Hajime ; Niinou, Kenji ; Sunakawa, Keisuke ; Yokota, Takao ; Nitta, Yasuko ; Akita, Hironobu ; Iwata, Satoshi ; Sato, Yoshitake ; Hachimori, Kei ; Noda, Masako ; Toyonaga, Yoshikiyo ; Yamori, Kazuko ; Hatakeyama, Kazuo ; Seo, Kiwamu ; Kawamura, Kenichi ; Nakamura, Hironori ; Toyoda, Shigeru ; Okabe, Nobuhiko ; Katayama, Akira ; Kato, Yoko ; Terashima, Itaru ; Meguro, Hidenori ; Mori, Atsuo ; Kurosaki, Tomomichi ; Toba, Tsuyoshi ; Nakamura, Akira ; Niimi, Hiroo ; Suzuki, Hiroshi ; Iwai, Naoichi ; Taneda, Yoichi ; Nakamura, Haruhi ; Kuno, Kuniyoshi ; Nishimura, Tadashi ; Tabuki, Kazuo ; Aoki, Shigeyuki ; Takagi, Michio ; Kobayashi, Yutaka ; Haruta, Tsunekazu ; Kuroki, Shigekazu ; Okura, Kanetsu ; Nishi, Hiroyuki ; Nishio, Toshikazu ; Motohiro, Takashi ; Sasaki, Hirokazu ; Aramaki, Masafumi ; Sakata, Yasutaka ; Yamashita, Fumio. / Pharmacokinetic and clinical studies with meropenem in the pediatric field. In: The Japanese Journal of Antibiotics. 1992 ; Vol. 45, No. 6. pp. 697-717.
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title = "Pharmacokinetic and clinical studies with meropenem in the pediatric field",
abstract = "Pharmacokinetic and clinical evaluations in pediatrics were made on meropenem (SM-7338, MEPM), a new parenteral dehydropeptidase-1 stable carbapenem used without any inhibitors, at 33 medical institutions. The results are summerized as follows. 1. Pharmacokinetic studies MEPM at a dose of 10, 20, or 40 mg/kg was administered to 53 children by 30-minute drip infusion. Peak plasma concentrations (Cmax's) and plasma half-lives (T 1/2's) of these doses were 28.5, 47.2 and 130.0μg/ml, and 0.80, 0.93 and 0.94 hours, respectively. A clear dose response was observed in Cmax's and T 1/2 values were quite similar to those observed in adults. In the first 6 hours after administration, 54.4 to 68.1{\%} of the administered drug was recovered in urine. The cerebrospinal fluid (CSF) levels of MEPM in patients with purulent meningitis were 0.13 μg/ml at a dose of 6 mg/kg, and 0.64 to 4.22 μg/ml at a dose of 29 to 44 mg/kg within day 4 of onset. The penetration rate of MEPM showed an intermediate value among those for other cephalospolin antibiotics. 2. Clinical study Clinical efficacies of MEPM were evaluated in 389 cases. The most common doses used were 10 to 20 mg/kg/once, 2 to 3 times a day. The maximum dose was 173 mg/kg/day q.i.d. MEPM gave “exellent” or “good” responces in 242 (97.6{\%}) out of 248 cases in which causative organisms were documented and in 134 (95.0{\%}) out of 141 cases in which causative organisms were not identified. Clinical efficacy rates were 100{\%} in 11 patients with purulent meningitis, 85.7{\%} in 7 with septicemia, 98.8{\%} in 173 with pneumonia, and 100{\%} in 65 with UTI. Bacteriologically, 260 strains (96.7{\%}) out of 269 strains were eradicated by MEPM treatment. Eradication rates were 89.2{\%} for Staphylococcus aureus (37 strains) and 100{\%} for Streptococcus pneumoniae (35 strains). The overall eradication rate for Gram-positive bacteria was 94.6{\%}. Among Gram-negative bacteria, 98.3{\%} out of 172 strains were eradicated. The eradication rate of Haemophilus influenzae (73 strains) was 98.6{\%} and Pseudomonas aeruginosa (11 strains) was 90.9{\%}, and all of Branhamella catarrhalis (15 strains), Escherichia coli (42 strains), and Klebsiella pneumoniae (6 strains) were eradicated. Out of 84 cases for which previous antibiotic therapies of 3 days or longer were not successful, MEPM gave “exellent” or “good” responces in 77 cases (91.7{\%}) and exellent bacteriological responces (95.7{\%}). 3. Side effects and laboratory test results Among 403 cases, 6 symptoms were noted as side effects in 5 cases including diarrhea, rash, watery stools and loose stools. Abnormal laboratory results occurred in 58 cases including increases in GOT, GPT, 7-GTP, LDH, LAP and eosinophil counts, and decrease in neutrophil counts. Based on these results, we concluded that the standard dose of MEPM in pediatrics would be 10 to 20 mg/kg/once, 2 to 3 times a day. The dosage may be altered according to symptoms. In conclusion, MEPM is a useful and safe drug for the treatment of various infections in children including severe infectious diseases such as purulent meningitis and septicemia.",
author = "Ryochi Fujii and Hajime Yoshioka and Kozo Fujita and Shizuo Maruyama and Hiroshi Sakata and Fumie Inyaku and Syunzo Chiba and Hiroyuki Tsutsumi and Yoshinori Wagatsuma and Naoki Fukushima and Akashi Ishikawa and Aiko Takase and Akira Watanabe and Kenji Sato and Masaru Yokoyama and Kyoichi Kawauchi and Yoshihiro Takahashi and Tadanori Okamoto and Toshiaki Abe and Tsuyoshi Tajima and Haruo Ichihashi and Nobuo Watanabe and Hiroo Matsuda and Kenichi Mikuni and Susumu Nakazawa and Hajime Sato and Kenji Niinou and Keisuke Sunakawa and Takao Yokota and Yasuko Nitta and Hironobu Akita and Satoshi Iwata and Yoshitake Sato and Kei Hachimori and Masako Noda and Yoshikiyo Toyonaga and Kazuko Yamori and Kazuo Hatakeyama and Kiwamu Seo and Kenichi Kawamura and Hironori Nakamura and Shigeru Toyoda and Nobuhiko Okabe and Akira Katayama and Yoko Kato and Itaru Terashima and Hidenori Meguro and Atsuo Mori and Tomomichi Kurosaki and Tsuyoshi Toba and Akira Nakamura and Hiroo Niimi and Hiroshi Suzuki and Naoichi Iwai and Yoichi Taneda and Haruhi Nakamura and Kuniyoshi Kuno and Tadashi Nishimura and Kazuo Tabuki and Shigeyuki Aoki and Michio Takagi and Yutaka Kobayashi and Tsunekazu Haruta and Shigekazu Kuroki and Kanetsu Okura and Hiroyuki Nishi and Toshikazu Nishio and Takashi Motohiro and Hirokazu Sasaki and Masafumi Aramaki and Yasutaka Sakata and Fumio Yamashita",
year = "1992",
doi = "10.11553/antibiotics1968b.45.697",
language = "English",
volume = "45",
pages = "697--717",
journal = "The Journal of antibiotics. Ser. B",
issn = "0368-2781",
publisher = "Japan Antibiotics Research Association",
number = "6",

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TY - JOUR

T1 - Pharmacokinetic and clinical studies with meropenem in the pediatric field

AU - Fujii, Ryochi

AU - Yoshioka, Hajime

AU - Fujita, Kozo

AU - Maruyama, Shizuo

AU - Sakata, Hiroshi

AU - Inyaku, Fumie

AU - Chiba, Syunzo

AU - Tsutsumi, Hiroyuki

AU - Wagatsuma, Yoshinori

AU - Fukushima, Naoki

AU - Ishikawa, Akashi

AU - Takase, Aiko

AU - Watanabe, Akira

AU - Sato, Kenji

AU - Yokoyama, Masaru

AU - Kawauchi, Kyoichi

AU - Takahashi, Yoshihiro

AU - Okamoto, Tadanori

AU - Abe, Toshiaki

AU - Tajima, Tsuyoshi

AU - Ichihashi, Haruo

AU - Watanabe, Nobuo

AU - Matsuda, Hiroo

AU - Mikuni, Kenichi

AU - Nakazawa, Susumu

AU - Sato, Hajime

AU - Niinou, Kenji

AU - Sunakawa, Keisuke

AU - Yokota, Takao

AU - Nitta, Yasuko

AU - Akita, Hironobu

AU - Iwata, Satoshi

AU - Sato, Yoshitake

AU - Hachimori, Kei

AU - Noda, Masako

AU - Toyonaga, Yoshikiyo

AU - Yamori, Kazuko

AU - Hatakeyama, Kazuo

AU - Seo, Kiwamu

AU - Kawamura, Kenichi

AU - Nakamura, Hironori

AU - Toyoda, Shigeru

AU - Okabe, Nobuhiko

AU - Katayama, Akira

AU - Kato, Yoko

AU - Terashima, Itaru

AU - Meguro, Hidenori

AU - Mori, Atsuo

AU - Kurosaki, Tomomichi

AU - Toba, Tsuyoshi

AU - Nakamura, Akira

AU - Niimi, Hiroo

AU - Suzuki, Hiroshi

AU - Iwai, Naoichi

AU - Taneda, Yoichi

AU - Nakamura, Haruhi

AU - Kuno, Kuniyoshi

AU - Nishimura, Tadashi

AU - Tabuki, Kazuo

AU - Aoki, Shigeyuki

AU - Takagi, Michio

AU - Kobayashi, Yutaka

AU - Haruta, Tsunekazu

AU - Kuroki, Shigekazu

AU - Okura, Kanetsu

AU - Nishi, Hiroyuki

AU - Nishio, Toshikazu

AU - Motohiro, Takashi

AU - Sasaki, Hirokazu

AU - Aramaki, Masafumi

AU - Sakata, Yasutaka

AU - Yamashita, Fumio

PY - 1992

Y1 - 1992

N2 - Pharmacokinetic and clinical evaluations in pediatrics were made on meropenem (SM-7338, MEPM), a new parenteral dehydropeptidase-1 stable carbapenem used without any inhibitors, at 33 medical institutions. The results are summerized as follows. 1. Pharmacokinetic studies MEPM at a dose of 10, 20, or 40 mg/kg was administered to 53 children by 30-minute drip infusion. Peak plasma concentrations (Cmax's) and plasma half-lives (T 1/2's) of these doses were 28.5, 47.2 and 130.0μg/ml, and 0.80, 0.93 and 0.94 hours, respectively. A clear dose response was observed in Cmax's and T 1/2 values were quite similar to those observed in adults. In the first 6 hours after administration, 54.4 to 68.1% of the administered drug was recovered in urine. The cerebrospinal fluid (CSF) levels of MEPM in patients with purulent meningitis were 0.13 μg/ml at a dose of 6 mg/kg, and 0.64 to 4.22 μg/ml at a dose of 29 to 44 mg/kg within day 4 of onset. The penetration rate of MEPM showed an intermediate value among those for other cephalospolin antibiotics. 2. Clinical study Clinical efficacies of MEPM were evaluated in 389 cases. The most common doses used were 10 to 20 mg/kg/once, 2 to 3 times a day. The maximum dose was 173 mg/kg/day q.i.d. MEPM gave “exellent” or “good” responces in 242 (97.6%) out of 248 cases in which causative organisms were documented and in 134 (95.0%) out of 141 cases in which causative organisms were not identified. Clinical efficacy rates were 100% in 11 patients with purulent meningitis, 85.7% in 7 with septicemia, 98.8% in 173 with pneumonia, and 100% in 65 with UTI. Bacteriologically, 260 strains (96.7%) out of 269 strains were eradicated by MEPM treatment. Eradication rates were 89.2% for Staphylococcus aureus (37 strains) and 100% for Streptococcus pneumoniae (35 strains). The overall eradication rate for Gram-positive bacteria was 94.6%. Among Gram-negative bacteria, 98.3% out of 172 strains were eradicated. The eradication rate of Haemophilus influenzae (73 strains) was 98.6% and Pseudomonas aeruginosa (11 strains) was 90.9%, and all of Branhamella catarrhalis (15 strains), Escherichia coli (42 strains), and Klebsiella pneumoniae (6 strains) were eradicated. Out of 84 cases for which previous antibiotic therapies of 3 days or longer were not successful, MEPM gave “exellent” or “good” responces in 77 cases (91.7%) and exellent bacteriological responces (95.7%). 3. Side effects and laboratory test results Among 403 cases, 6 symptoms were noted as side effects in 5 cases including diarrhea, rash, watery stools and loose stools. Abnormal laboratory results occurred in 58 cases including increases in GOT, GPT, 7-GTP, LDH, LAP and eosinophil counts, and decrease in neutrophil counts. Based on these results, we concluded that the standard dose of MEPM in pediatrics would be 10 to 20 mg/kg/once, 2 to 3 times a day. The dosage may be altered according to symptoms. In conclusion, MEPM is a useful and safe drug for the treatment of various infections in children including severe infectious diseases such as purulent meningitis and septicemia.

AB - Pharmacokinetic and clinical evaluations in pediatrics were made on meropenem (SM-7338, MEPM), a new parenteral dehydropeptidase-1 stable carbapenem used without any inhibitors, at 33 medical institutions. The results are summerized as follows. 1. Pharmacokinetic studies MEPM at a dose of 10, 20, or 40 mg/kg was administered to 53 children by 30-minute drip infusion. Peak plasma concentrations (Cmax's) and plasma half-lives (T 1/2's) of these doses were 28.5, 47.2 and 130.0μg/ml, and 0.80, 0.93 and 0.94 hours, respectively. A clear dose response was observed in Cmax's and T 1/2 values were quite similar to those observed in adults. In the first 6 hours after administration, 54.4 to 68.1% of the administered drug was recovered in urine. The cerebrospinal fluid (CSF) levels of MEPM in patients with purulent meningitis were 0.13 μg/ml at a dose of 6 mg/kg, and 0.64 to 4.22 μg/ml at a dose of 29 to 44 mg/kg within day 4 of onset. The penetration rate of MEPM showed an intermediate value among those for other cephalospolin antibiotics. 2. Clinical study Clinical efficacies of MEPM were evaluated in 389 cases. The most common doses used were 10 to 20 mg/kg/once, 2 to 3 times a day. The maximum dose was 173 mg/kg/day q.i.d. MEPM gave “exellent” or “good” responces in 242 (97.6%) out of 248 cases in which causative organisms were documented and in 134 (95.0%) out of 141 cases in which causative organisms were not identified. Clinical efficacy rates were 100% in 11 patients with purulent meningitis, 85.7% in 7 with septicemia, 98.8% in 173 with pneumonia, and 100% in 65 with UTI. Bacteriologically, 260 strains (96.7%) out of 269 strains were eradicated by MEPM treatment. Eradication rates were 89.2% for Staphylococcus aureus (37 strains) and 100% for Streptococcus pneumoniae (35 strains). The overall eradication rate for Gram-positive bacteria was 94.6%. Among Gram-negative bacteria, 98.3% out of 172 strains were eradicated. The eradication rate of Haemophilus influenzae (73 strains) was 98.6% and Pseudomonas aeruginosa (11 strains) was 90.9%, and all of Branhamella catarrhalis (15 strains), Escherichia coli (42 strains), and Klebsiella pneumoniae (6 strains) were eradicated. Out of 84 cases for which previous antibiotic therapies of 3 days or longer were not successful, MEPM gave “exellent” or “good” responces in 77 cases (91.7%) and exellent bacteriological responces (95.7%). 3. Side effects and laboratory test results Among 403 cases, 6 symptoms were noted as side effects in 5 cases including diarrhea, rash, watery stools and loose stools. Abnormal laboratory results occurred in 58 cases including increases in GOT, GPT, 7-GTP, LDH, LAP and eosinophil counts, and decrease in neutrophil counts. Based on these results, we concluded that the standard dose of MEPM in pediatrics would be 10 to 20 mg/kg/once, 2 to 3 times a day. The dosage may be altered according to symptoms. In conclusion, MEPM is a useful and safe drug for the treatment of various infections in children including severe infectious diseases such as purulent meningitis and septicemia.

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