Pharmacokinetics of teicoplanin in burn patients.

The pharmacokinetics of teicoplanin were studied in 21 adult burn patients and in 5 healthy controls. All subjects were given a single dose of teicoplanin, 10 mg/kg i.v. The pharmacokinetic parameters of teicoplanin were calculated using a tri-exponential model. Three parameters were investigated--burn surface area, creatinine clearance and time of administration after injury (3 days, 8-10 days and 15-20 days respectively). The elimination half-life was not significantly different between the control group (47 +/- 6 hours), the group with a burn surface area greater than 40% (64 +/- 38 hours), and the group with a burn surface area of 25-30% (44 +/- 15 hours). Trough serum concentrations at 12 hours were consistently less than 8 mg/l in all groups. There was some degree of correlation between creatinine clearance and renal clearance of teicoplanin (p = 0.03; r = 0.44). However, there was no correlation between burn surface area and creatinine clearance, or between the time of administration and creatinine clearance. Non-renal clearance of teicoplanin was unaffected by a large burn surface area. The conclusions from this study are as follows. Burn surface area and time of administration after injury are not predictive factors for the determination of an appropriate dose regimen. Trough serum concentrations at 12 hours emphasize the need for a further intravenous bolus. Burn patients with a high creatinine clearance (greater than 140 ml/min) should be carefully monitored.

[Electroclinical aspects of intramuscular methohexital anesthesia in children]. / Aspects éléctrocliniques de l'anesthésie au méthohexital intramusculaire chez l'enfant.

Intramuscular methohexital is used in children for short-term anaesthesia. As a seizure was observed in two of our cases after administration of this barbiturate, an EEG study was performed. The EEG pattern was characterized by a particularly slow, sharp, high voltage stage with a decrease of fast rhythms (stage 3a), then fast and sharp rhythms becoming more and more frequent (stage 3b). These stages were particularly pronounced and prolonged in children over 3 years of age, with myoclonic jerks observed in 6 cases, beginning about 3 min after methohexital injection and at the same time as the clinical seizures. These results are discussed in terms of previously reported descriptions of barbiturate anaesthesia, and especially of i.m. or i.v. methohexital anaesthesia. This anaesthetic, although reliable and easy to use, should in our opinion be avoided in epileptic children.