Ceftazidime in the treatment of neonatal infection

Pollock, I; Mulhall, Anne; Louvois, J de

doi:10.1016/s0195-6701(85)80093-1

Cited by 17 publications

(6 citation statements)

References 6 publications

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“…This difference was not apparent in patients who received CAZ monotherapy partly due to the fact that there were some treatment failures due to listeria and enterococci in the CAZ monotherapy group. This latter finding is in agreement with previous reports [6,[15][16][17]. We are not aware of a previous investigation in which CAZ+AMP was used.…”

Section: Discussionsupporting

confidence: 94%

“…The absence of reports, in this study, of serious sideeffects from treatment with CAZ is in agreement with findings reported previously [15][16][17]. In some patients parameters of renal and hepatic function, notably alanine aminotransferase, rise during the course of treatment with ceftazidime and other third generation cephalosporins.…”

Section: Discussionsupporting

confidence: 93%

“…A number of previous studies [6,8,11,[14][15][16][17][18] have shown that CAZ is comparable to an AG plus a penicillin for the treatment of neonatal sepsis. The majority of these studies have been small and in many of them relatively few cases of confirmed sepsis were unevenly distributed between the treatment arms.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of ceftazidime and aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn

Louvois¹,

Dagan

Tessin

1992

Eur J Pediatr

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We report a prospective, non-blind, randomised, multicentre, parallel group, multinational investigation to compare ceftazidime to aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn. In each of the 15 study centres either ceftazidime alone (CAZ) or ceftazidime + ampicillin (CAZ + AMP) was compared to an amino-glycoside/ampicillin combination (AG + AMP). In all cases treatment was based on "an intention to treat". Bacteria considered to be pathogenic were isolated from 176/1316 (13.4%) patients. The incidence of proven infection varied from 39% in a Yugoslav centre to 6% in a British centre; a further 489/1316 (37.1%) patients fulfilled the criteria for clinically suspected sepsis. A total of 210 bacterial isolates from 197 infection sites in 176 patients were considered to be clinically significant. The cure rate for evaluable patients with proven infection who were treated with CAZ + AMP (97%, 30/31) was significantly higher than that for the corresponding patients treated with AG + AMP (66%, 26/39), (P < 0.002). The difference in cure rate between CAZ monotherapy (79%, 34/43) and AG + AMP (86%, 32/37) was not significant. Treatment failed in 28/150 (18.7%) evaluable patients. There were significantly fewer failures (P < 0.001) with CAZ + AMP than with AG + AMP therapy. There were 55 staphylococcal infections. Treatment was successful in 16/19 evaluable patients treated with CAZ or CAZ + AMP and in 16/29 evaluable patients treated with AG + AMP. None of the study centres encountered problems with ceftazidime resistant bacteria. The cure rate for patients with only clinical and radiological evidence of sepsis was greater than 94% in all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

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A comparison of ceftazidime and aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn

Louvois¹,

Dagan

Tessin

1992

Eur J Pediatr

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“…Older neonates and infants (aged 1 to 81 days) were also included in those two studies, making their population and ours (neonates aged up to 5 days) difficult to compare. However, three relatively older studies conducted with term and preterm neonates showed CL values similar to ours, i.e., 0.04 L/h/kg in term asphyxiated neonates and 0.01 to 0.13 L/h/kg in preterm neonates (17)(18)(19).…”

Section: Discussionsupporting

confidence: 84%

Population Pharmacokinetics and Dosing Optimization of Ceftazidime in Term Asphyxiated Neonates during Controlled Therapeutic Hypothermia

Veer

Haan

Franken

et al. 2023

Antimicrob Agents Chemother

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Ceftazidime is an antibiotic commonly used to treat bacterial infections in term neonates undergoing controlled therapeutic hypothermia (TH) for hypoxic-ischemic encephalopathy after perinatal asphyxia. We aimed to describe the population pharmacokinetics (PK) of ceftazidime in asphyxiated neonates during hypothermia, rewarming, and normothermia and propose a population-based rational dosing regimen with optimal PK/pharmacodynamic (PD) target attainment.

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“…If the current dosing regimen showed underdosing in the majority of patients (Ͼ50%), the optimal dosing regimen with an increased dose and/or frequency was given to the virtual patients (32)(33)(34). Thus, various dosing regimens (10,15,20,25,30,35,40,45, and 50 mg/kg q12h and q8h) were simulated in this group. The probability of target attainment is calculated for each dosing regimen to optimize antimicrobial therapy.…”

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confidence: 99%

Population Pharmacokinetics and Dosing Optimization of Ceftazidime in Infants

Shi

Chen

Tian

et al. 2018

Antimicrob Agents Chemother

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Ceftazidime, a third-generation cephalosporin, can be used for the treatment of adults and children with infections due to susceptible bacteria. To date, the pediatric pharmacokinetic data are limited in infants, and therefore we aimed to evaluate the population pharmacokinetics of ceftazidime in infants and to define the appropriate dose to optimize ceftazidime treatment. Blood samples were collected from children treated with ceftazidime, and concentrations of the drug were quantified by high-performance liquid chromatography with UV detection (HPLC-UV). A population pharmacokinetic analysis was performed using NONMEM software version 7.2.0). Fifty-one infantsage range, 0.1 to 2.0 years were included. Sparse pharmacokinetic samples = 90 were available for analysis. A one-compartment model with first-order elimination showed the best fit with the data. A covariate analysis identified that body weight and creatinine clearance (CL) were significant covariates influencing ceftazidime clearance. Monte Carlo simulation demonstrated that the currently used dosing regimen of 50 mgkg twice daily was associated with a high risk of underdosing in infants. In order to reach the target of 70% of the time that the free antimicrobial drug concentration exceeds the MIC (), 25 mg/kg every 8 h (q8h) and 50 mg/kg q8h were required for MICs of 4 and 8 mg/liter, respectively. The population pharmacokinetic characteristics of ceftazidime were evaluated in infants. An evidence-based dosing regimen was established based on simulation.

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Ceftazidime in the treatment of neonatal infection

Cited by 17 publications

References 6 publications

A comparison of ceftazidime and aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn

A comparison of ceftazidime and aminoglycoside based regimens as empirical treatment in 1316 cases of suspected sepsis in the newborn

Population Pharmacokinetics and Dosing Optimization of Ceftazidime in Term Asphyxiated Neonates during Controlled Therapeutic Hypothermia

Population Pharmacokinetics and Dosing Optimization of Ceftazidime in Infants

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