PHARMACOKINETICS AND CLINICAL EVALUATION OF AZTREONAM IN PEDIATRIC SURGERY

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  • YURA JIRO
    The First Department of Surgery, Nagoya City University Medical School
  • SUZUKI TATSUYA
    The First Department of Surgery, Nagoya City University Medical School
  • HASHIMOTO TAKASHI
    The First Department of Surgery, Nagoya City University Medical School
  • NAKAMURA TSUKASA
    The First Department of Surgery, Nagoya City University Medical School
  • SHIMIZU YASUNOBU
    The First Department of Surgery, Nagoya City University Medical School
  • MINAMI MUNEHITO
    The First Department of Surgery, Nagoya City University Medical School
  • KAMIYA YASUHIRO
    The First Department of Surgery, Nagoya City University Medical School
  • NARITA HIROSHI
    The First Department of Surgery, Nagoya City University Medical School
  • TSURUGA NOBUATSU
    The First Department of Surgery, Nagoya City University Medical School

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Other Title
  • 小児外科領域におけるAztreonamの基礎的臨床的検討

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Abstract

Pharmacokinetic and clinical studies on aztreonam (AZT) in pediatric surgery were performed and results obtained are summarized below.<BR>1. Plasma and urinary levels of AZT were measured in 6 neonate patients following dripinfusion for 1 hour of AZT (dose of AZT: 20 mg/kg). Plasma levels reached their peak (42.3-50.4 μg/ml) at the end of infusion or in 1 hour thereafter except in case 2. In case 2, plasma level reached its peak (36.6 μg/ml) at 2 hours after the end of infusion. Plasma levels of AZT decreased rapidly after reaching their peaks, and plasma half-lives (T 1/2) were 1.85-2.84 hours. Urinary recovery rates were 15.7-65.3%.<BR>2. Bile levels of AZT were determined in 8 patients with biliary atresia following 1 hour drip-infusion of AZT (dose of AZT: 20 mg/kg for 4 patients, 40 mg/kg for the other 4 patients). In the 20 mg/kg group, peak levels of AZT in bile were noted 2 hours after the end of infusion, and they were 3.7-7.1 μg/ml. Recovery rates in bile in the first 6 hours after the end of infusion were 0.34-0.9%. In the 40 mg/kg group, peak levels of AZT in bile were found at 2 hours and 2-4 hours after the end of infusion, and they were 4.9-8.8 μg/ml. Recovery rates in bile in the first 6 hours after the end of infusion were 0.03-0.33%.<BR>3. AZT and ampicillin were administered to 6 patients as prophylaxis against postoperative infections. Another patient with postoperative cholangitis was given AZT alone. No infectious complications, or clinical or laboratory adverse reactions due to the administration of AZT were observed in the patients upon the prophylactic use. In the patient with cholangitis, clinical effect was good but the organism in his bile was not eradicated.<BR>It is conculuded that AZT is an effective and safe antibiotics in pediatric surgery.

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