Pharmacologic studies in neonates given large dosages of ampicillin

Kaplan, J. Martin; McCracken, George H.; Horton, Linda; Thomas, Marion L.; Davis, N.R.

doi:10.1016/s0022-3476(74)80684-0

Cited by 73 publications

(43 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We assessed platelet function before and after ampicillin dosing, using the template bleeding time and the PFA-100 times. The peak serum level of ampicillin in the blood is expected just after intravenous dosing, and the half-life in neonates is approximately 5 h. 23,24 However, the adverse effect of ampicillin on platelet function appears not to be temporally related to its peak serum concentration, but is a cumulative effect. 4,7,9 Thus, to cover a wide range of possibilities, we obtained platelet function studies at intervals ranging from 2 h after the first dose to 12 h after the fourth dose.…”

Section: Discussionmentioning

confidence: 99%

“…We suggest that more study is needed to quantify the effect of ampicillin on bleeding in such patients, to define any dose-effect relationships, and to define any additive effects on bleeding tendency when ampicillin is used along with other medications or treatments that have anti-platelet effects, such as nitric oxide 25,26 or indomethacin. 23,24 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of ampicillin on the bleeding time of neonatal intensive care unit patients

et al. 2009

View full text Add to dashboard Cite

Objective: Studies in adults indicate that ampicillin, in a dose-dependent manner, impairs platelet function and moderately prolongs the bleeding time (generally by 60 to 90 s). Unlike aspirin, the inhibition induced by ampicillin involves both reversible and irreversible mechanisms and is not observed immediately after initial dosing (generally requiring approximately 24 h). Ampicillin is administered commonly to neonatal intensive care unit (NICU) patients, but its effect on bleeding time in this population has not been reported earlier.Study Design: We performed neonatal template bleeding times and platelet function analyzer (PFA)-100 tests on 15 NICU patients before and at various intervals after intravenous ampicillin dosing.Result: Neonates were only studied if no beta-lactam antibiotics were administered to their mother during labor, and if they had ampicillin ordered by the clinician at a dose of 50 to 100 mg kg -1 every 12 h. Subjects ranged from 33 to 41 weeks gestation and weighed 1760 to 3835 g. Bleeding times before the first ampicillin dose (n ¼ 15) averaged 134 s (95% confidence interval (CI), 120 to 148 s) and PFA-100 times averaged 123 s (95% CI, 96 to 149 s). After the first dose of ampicillin (n ¼ 5), bleeding times and PFA-100 times did not increase, but after the third (n ¼ 5) and fourth doses (n ¼ 4) bleeding times lengthened by an average of 60 s (95% CI, 37 to 83 s, P<0.001) and PFA-100 times lengthened by an average of 20 s (95% CI, À20 to 60 s, P ¼ 0.15).Conclusion: Ampicillin administered intravenously to NICU patients prolongs the bleeding time, with a magnitude-of-effect and time-to-effect similar to that shown earlier in adults.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of ampicillin on the bleeding time of neonatal intensive care unit patients

et al. 2009

View full text Add to dashboard Cite

show abstract

“…These studies confirmed that preterm neonates have a longer t ½ (4-5.5 h) [11,12] and that the t ½ decreases rapidly with postnatal age during the first few weeks of life [12].…”

Section: Ampicillinmentioning

confidence: 56%

“…Those studies that have been carried out show that both GA and PNA have an impact on clearance and hence plasma t ½ [5,11,12,15,17,20,27,29]. Most of these PK studies have been classical PK studies where several blood samples were taken from each infant.…”

Section: Discussionmentioning

confidence: 99%

“…Original studies of ampicillin PK in neonates did not provide extensive details of either gestational age (GA) or weight [8][9][10][11][12], but instead focused on t ½ and peak plasma concentrations ( Table 2). These studies confirmed that preterm neonates have a longer t ½ (4-5.5 h) [11,12] and that the t ½ decreases rapidly with postnatal age during the first few weeks of life [12].…”

Section: Ampicillinmentioning

confidence: 99%

See 1 more Smart Citation

Clinical pharmacokinetics of penicillins in the neonate: a review of the literature

Pacifici

Labatia

Mulla

et al. 2008

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Sepsis is common in neonates and a major cause of morbidity and mortality. Sixty percent of preterm neonates receive at least one antibiotic during the first week of life, with penicillins being the most frequently administered antibiotics. The clearance (Cl), serum half-life (t(A1/2)) and volume of distribution (Vd) of penicillins are different in the neonate than in the adult. As such, the pharmacokinetics of penicillins need be studied in neonates in order to optimise therapy in this age class with these drugs. The aim of this study was to review the published data on the pharmacokinetics of penicillins in the neonate in order to provide a critical analysis of the literature and, consequently, a useful tool in the hands of the physician. The bibliographic search was performed electronically using the PubMed and EMBASE databases as search engines. An initial search was performed with the keywords "pharmacokinetics", "penicillins" and "neonates". Secondly, other searches were performed using the keywords "pharmacokinetics" and "neonates", followed by the name of a single antibiotic. The search included articles up to 2007. There have been few pharmacokinetic studies on the use of penicillins in neonates. The results from those few studies that have been carried out suggest that the Cl is reduced and t(A1/2) prolonged in the neonate as compared with the more mature infant. There is little variation in Vd during the first week of life. In the premature neonate, Cl is reduced compared to the full-term infant. As postnatal age proceeds, the Cl of penicillins increases. More pharmacokinetic studies are required to provide a sound scientific basis for planning a dosage regimen with penicillins in the neonate

show abstract

Pharmacological Basis for Antimicrobial Therapy in Newborn Infants

McCracken¹

1974

Arch Pediatr Adolesc Med

Self Cite

View full text Add to dashboard Cite

Pharmacologic studies in neonates given large dosages of ampicillin

Cited by 73 publications

References 11 publications

Effect of ampicillin on the bleeding time of neonatal intensive care unit patients

Effect of ampicillin on the bleeding time of neonatal intensive care unit patients

Clinical pharmacokinetics of penicillins in the neonate: a review of the literature

Pharmacological Basis for Antimicrobial Therapy in Newborn Infants

Contact Info

Product

Resources

About