Experiences with ceftazidime in the therapy of neonatal infections

Abstract

Our experience of ceftazidime during the last three years has in almost every respect been favourable. As monotherapy it has resulted in clinical responses at least as good as those from gentamicin and ampicillin. The pharmacokinetics and activity of ceftazidime are far superior to those of gentamicin. We have not been able to demonstrate any significant haematological or biochemical side effects of ceftazidime therapy nor does it adversely affect neonatal blood clotting mechanisms. The incidence of superficial candidosis has not changed during the last three years. Use of third generation cephalosporins has resulted in an increase in neonatal colonisation with faecal streptococci but this has not resulted in any clinical problems. We have not observed any increase in the number of isolates of Enterobacter spp. nor has there been an increase in the number of ceftazidime resistant microorganisms including Clostridium difficile, since ceftazidime was introduced. Drug accumulation does not occur in neonates receiving 25 mg/kg 12 hourly and throughout the dosage interval the serum therapeutic ratio for ceftazidime against common neonatal pathogens is superior to that of gentamicin with penicillin or ampicillin.