ABSTRACT
Single-dose pharmacokinetic studies were performed in 64 infants, ranging in age from less than 1 day to 6 days, after intravenous infusion or intramuscular injection of approximately 75 mg/kg of mezlocillin. Mean serum concentrations at one hour were 107 micrograms/ml and 82.5 micrograms/ml for neonates less than or equal to 1 day of age and greater than or equal to 6 days of age, respectively. The serum clearance ranged from 3.0 to 6.4 hours. Based on data from the study, it is recommended that mezlocillin be administered to neonates with gram-negative bacterial infections in a single dose of 75 mg/kg, either as an intravenous infusion over 30 minutes or as an intramuscular injection, every 12 hours during the first week of life. Mezlocillin alone or in conjunction with penicillin was used in treating 165 neonates with suspected sepsis. Gram-negative organisms were recovered from 18 of the 27 neonates from whom pathogens were isolated. Three of these 18 strains, a Klebsiella oxytoca, an Acinetobacter anitratum, and a Haemophilus influenzae, were resistant to mezlocillin in vitro. Twenty-four of the 27 patients who satisfied criteria for evaluation achieved a bacteriological and a clinical cure. Cerebrospinal fluid permeation after multiple doses ranged from 18% to 45% of serum levels. No significant local or systemic side effects were seen. The results indicate that mezlocillin is an effective ureidopenicillin for the treatment of gram-negative bacterial infections.
Subject(s)
Bacterial Infections/drug therapy , Infant, Newborn, Diseases/drug therapy , Mezlocillin/therapeutic use , Blood-Brain Barrier/drug effects , Enterocolitis/drug therapy , Female , Half-Life , Humans , Infant, Newborn , Kinetics , Male , Meningitis/drug therapy , Mezlocillin/metabolism , Mezlocillin/toxicity , Pneumonia/drug therapy , Time FactorsSubject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Infant, Newborn, Diseases/drug therapy , Penicillins/therapeutic use , Aminoglycosides/therapeutic use , Bacteria/drug effects , Female , Humans , Infant, Newborn , Male , Mezlocillin , Penicillins/adverse effects , Penicillins/metabolismABSTRACT
All indexed cases of typhoid fever occurring in children over a ten-year period in Jacksonville, Fla, were studied retrospectively. This review revealed that anorexia was the most common gastrointestinal complaint and that neurologic symptoms and signs were nearly as common as gastrointestinal signs. There was a significant delay in diagnosis in most cases because typhoid fever was not included in the differential diagnosis upon admission. This is probably due to the decline in the incidence of typhoid fever in the United States and the resultant lowering of the index of suspicion for the disease on the part of physicians in general. Representative cases are presented in detail.
