The use of sulfamerazine in infants and children

Abstract

Summary A study of the absorption, methods of administration, therapeutic effectiveness, and toxicity of sulfamerazine in an unselected group of 135 infants and children with infections revealed the following pertinent data: 1. Sulfamerazine is rapidly absorbed from the gastrointestinal tract and rather slowly excreted by the kidney. Accordingly, adequate blood concentrations are easily attained by the oral administration of 0.05 Gm. per kilogram of body weight every eight hours (three-quarters of the total daily dosage usually employed with sulfathiazole and sulfadiazine). Sulfamerazine thus possesses an advantage over the other sulfonamide drugs in that they must be given in larger total dosage with more frequent doses to attain comparable blood levels. 2. High blood concentrations are easily and rapidly produced by the subcutaneous administration of sodium sulfamerazine. The absorption of sulfamerazine from the gastrointestinal tract, although more rapid and complete than is the absorption of the other sulfonamide drugs, does not lead to values sufficiently high to obviate the need for parenteral administration of the drug when very high values are desired. 3. Sulfamerazine was observed to pass into the spinal fluid to the extentof from 52 to 83 per cent of the whole blood value and 41 to 73 per cent of the plasma value, while the concentration in pleural and ascitic fluid equaled that in the plasma. 4. From a purely clinical evaluation, the therapeutic effectiveness of sulfamerazine is entirely comparable to that of sulfapyrazine, sulfadiazine and, sulfathiazole. 5. The toxic reactions encountered were relatively frequent but, for the most part, were mild, and no serious reactions occurred. On the basis of our past experience, the frequency of toxic reactions was definitely greater with the use of sulfamerazine than with sulfapyrazine and certainly as great as with sulfadiazine.