Comparison between the combination of azlocillin-gentamicin and ampicillin-gentamicin in the treatment of a nursery population.
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.
D000667:Ampicillin / Q000008:administration & dosage*; D001390:Azlocillin; D001424:Bacterial Infections / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005839:Gentamicins / Q000008:administration & dosage*; D006207:Half-Life; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D007363:Intensive Care Units, Neonatal; D007700:Kinetics; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000008:administration & dosage* / Q000378:metabolism; D011446:Prospective Studies; D011897:Random Allocation
D005839:Gentamicins; D010406:Penicillins; D000667:Ampicillin; D001390:Azlocillin