Continuous infusion of ceftazidime in the empiric treatment of febrile neutropenic children with cancer.
OBJECTIVE
Infection remains one of the most important complications in cancer therapy. The choice of antibiotics and the method of administration can affect results. Beta-lactam antibiotics can be administered by several short injections per day or by continuous infusion. The latter modality may provide superior pharmacokinetics.


METHODS
The authors studied the pharmacokinetics of ceftazidime in children treated for malignancy and in febrile aplasia after chemotherapy. They received a continuous infusion of ceftazidime (200 mg/kg/day) after a loading dose (65 mg/kg/day) administered with amikacin (25 mg/kg/day) and vancomycin (50 mg/kg/day). RESULTS Twenty-three pharmacokinetic studies were performed. Mean ceftazidime serum levels were 31.1 +/- 11.9, 31.2 +/- 10, 32.4 +/- 11.6, 33 +/- 11.6, and 30.4 +/- 12.1 mg/L at 25, 27, 30, 36, and 43 hours, respectively. Treatment was tolerated well. There were no toxic or infectious deaths.


CONCLUSIONS
Ceftazidime's time-dependent pharmacokinetics shows the advantage of continuous infusion. This study confirmed the feasibility and safety of this administration schedule in the empiric treatment of febrile neutropenic children with cancer.
Dalle
Jean-Hugues
JH
Unité Protégée A, Hôpital Jeanne de Flandre, CHRU, Lille, France. jhdalle@wanadoo.fr
Gnansounou
Magloire
M
Husson
Marie-Odile
MO
Lambilliotte
Anne
A
Mazingue
Françoise
F
Nelken
Brigitte
B
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D002442:Ceftazidime / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D002442:Ceftazidime