Abstract
Ceftazidime(CAZ) is a broad spectrum antibiotic with activity against most neonatal pathogens including Ps.aeruginosa. It has proved efficacious in the treatment of infected neonates.The pharmacokinetics and safety of CAZ(25 mg/kg twice daily IV or IM were examined in 41 young premature neonates with clinical evidence of infection. CAZ was assayed in 46 series of blood samples by HPLC.Blood was collected before,during and after therapy for analysis of biochemical and haematological factors.Faecal specimens were examined for Cl.difficile and its toxin.pharmacokinetic parameters were:CMAX=72 6mg/l;CMIN=17 2mg/l;TMAX=1.5 0.3hrs;T1/2=8.6 1.2hrs;total body clearance(CL)=0.8 0.07ml/min/kg).CMAX(IV) CAZ was 77 8mg/l and CMAX(IM) was 56 7 mg/l.Therapeutic serum levels were maintained throughout the dosage interval in all babies. CL of CAZ increased with increasing postnatal age (p<0.0001) but was unaffected by birthweight or gestational age. Serum urea,electrolytes,urine sp.gr and body temperature had no effect of CAZ pharmacokinetics.These data were compared with studies of comparable babies receiving cefuroxime(24),cefotaxime(17),latamoxef (27),and gentamicin(31). Therapy had no significant effect on haematological or biochemical parameters.There was no increase in the isolation of Cl. difficile from stools.CAZ is a safe and effective drug for use in the treatment of neonates.25 mg/kg administered b.d. results in adequate serum concentrations with no accumulation in babies <7 days old.The serum therapeutic ratio for ceftazidime against common neonatal pathogens is superior to that of gentamicin and penicillin/ampicillin.
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