title: Cefotaxime pharmacokinetics and treatment of meningitis in neonates.
abstract: Pharmacokinetic studies on cefotaxime/desacetylcefotaxime were carried out in very low birth weight newborns (n = 18; 500-1500 g; 28.4 +/- 2.4 weeks gestational age) during the first week of life. We have previously reported that the elimination t 1/2 of cefotaxime (3.4-6.4 h) and desacetylcefotaxime (9.4 h) was longer than previously described in term infants and children. In very low birth weight neonates, a single 50 mg/kg daily dose of cefotaxime may produce accumulation of the metabolite desacetylcefotaxime in serum. In a non-comparative prospective clinical trail, 22 infants (one week - three months) were treated for gram-negative enteric bacillary meningitis with cefotaxime at a dosage of 50 mg/kg/day. The predominant pathogen was Escherichia coli in 14 cases and Enterobacter cloacae in four cases. Cultures of the cerebrospinal fluid obtained 24-48 h after the initiation of treatment were sterile in all subjects. Survival and complication rates of 95% and 19%, respectively, were observed. This compared favorably to previously published experiences with alternative treatment regimens for neonatal gram-negative enteric meningitis. In both the pharmacokinetic and meningitis studies, the safety profile for cefotaxime was excellent with no adverse reactions.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock.
authors.forename: R F
authors.initials: RF
authors.lastname: Jacobs
authors.forename: G L
authors.initials: GL
authors.lastname: Kearns
mesh_terms: D002439:Cefotaxime / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004927:Escherichia coli Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D002439:Cefotaxime