azlocillin and Infant--Premature--Diseases

Newborn, and particularly premature infants are prone to life-threatening infections. The combination of ampicillin-gentamicin (AM-G) has been used extensively in neonatal intensive care units (NICU). Because resistant bacteria emerged, a new drug--an acylureidopenicillin, azlocillin, with a wide antibacterial spectrum--has been developed. A prospective randomized study was performed in order to evaluate the combination of AM-G vs. azlocillin-gentamicin (AZ-G). Thirty neonates received AM-G and 28 received AZ-G. Definite infection was found in 15 AM-G patients and in 10 AZ-G patients. In these patients, the antibiotic regimen was changed in six of the AM-G and in one of the AZ-G patients. In each of the two treatment groups, one very-low-birth-weight baby died due to overwhelming sepsis. In vitro sensitivity to AZ-G was higher than to AM-G, according to azlocillin blood levels obtained. Infants weighting less than 2,350 g had lower clearance and volume of distribution than did infants weighing greater than 2,350 g. The serum half-life was approximately the same in both groups. It appears to be that in the NICU, the combination of AZ-G may be more effective than the AM-G combination.

Topics: Ampicillin; Azlocillin; Bacterial Infections; Drug Therapy, Combination; Gentamicins; Half-Life; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases; Intensive Care Units, Neonatal; Kinetics; Microbial Sensitivity Tests; Penicillins; Prospective Studies; Random Allocation

In-vitro and clinical efficacy of a combination therapy consisting of 3 antibiotic agents was to be assessed in neonatal septicemia.. From 1980 to 1987, 152 newborns with septicemia as proven by blood culture were treated with an initial antibiotic regimen consisting of azlocillin (150 mg/kg bw), cefotaxime (100 mg/kg bw), and tobramycin (5 mg/kg bw).. According to the microbiologic testing, antimicrobic therapy was effective in each of the 152 organisms: 101/152 bacteria were susceptible to all 3 agents; resistance to 1 or 2 of the antibiotics was evident in 33/152 and in 18/152 organisms, respectively. Mortality due to septicemia was 7.2%.. As no difference was observed in the frequency in which one of the three antibiotic substances was the only effective drug, each of the 3 agents seemed to be necessary for clinical effectiveness of this antibiotic combination.

Topics: Azlocillin; Bacteriological Techniques; Cefotaxime; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Microbial Sensitivity Tests; Risk Factors; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptococcus agalactiae; Tobramycin

Topics: Azlocillin; Bacterial Infections; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Infant, Premature, Diseases; Microbial Sensitivity Tests

A pharmacokinetic and clinical study was done in 25 newborn infants suffering predominantly from pseudomonas infections treated with azlocillin. After a single iv dose of 50 mg azlocillin per kg bodyweight in biphasic concentration time course suggested an open two compartment body model. There was a rapid diffusion between the peripheral and the central compartment. The elimination half life calculated from the beta-slope was 2.5-2.6 h, and differences between premature neonates with more than 2000 g body weight and mature neonates were absent. To maintain a median steady state concentration of 50-80 mg/l in the serum 100-200 mg azlocillin/kg body weight per day must be given. Using this dosage non-linear kinetics and an accumulation of the drug would not occur. Bacteriological and clinical results confirm that in neonatal reinfection, and bronchopulmonary and local infection caused by pseudomonas strains, azlocillin has favourable properties.

Topics: Azlocillin; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Injections, Intravenous; Kinetics; Male; Models, Biological; Penicillins; Pseudomonas Infections