1986 Volume 39 Issue 9 Pages 2458-2465
Using cefotiam (CTM) against infections in neonates and premature infants, we obtained the following results:
1. With intravenous administration of the drug to 2 cases each of pyoderma, pneumonia, and fetal infection, the drug was effective in all the cases except in 1 premature infant with pneumonia. Dose levels at individual injections were between 18.6 and 27.8mg/kg, per dose, with an exception in 1 case of pyoderma (36.4-54.5mg/kg), and 2 to 4 doses per day were given to each patient.
2. For prophylactic purposes, the drug was administered to 1 case of turbid amniotic fluid and 3 cases of massive aspiration syndrome, and no infection was observed in any case.
3. In a total of 11 cases consisting of the above mentioned 10 cases and an additional case which had been excluded from the evaluation because of the detection of P. aeruginosa, neither side effects nor abnormal laboratory values were recognized.
4. In 5 cases of 4 to 31-day old infants, CTM concentrations in blood were measured after one-time intravenous injection of the drug at a dose level of about 20mg/kg. Blood concentrations of CTM were low in 1 case with levels of 14.4 and 4.5μg/ml at 30 minutes and 2 hours after the intravenous injection, respectively, whereas they were high in another case with readings of 82 and 65μg/ml. In the remaining 3 cases, however, 30-minute and 2-hour values were between 41 to 52, and 13.5 to 22.8μg/ml, respectively. Half-lives of blood CTM levels were 0.91 to 2.94 hours, and they showed a tendency to be longer in those whose body weights at the time of birth were lower and also in the case of a 4-day old infant. The urinary recovery rate up to 6 hours after an intravenous injection was measured in 1 case to be 57.8%.
5. Adding some literature studies to the above results, we consider that CTM is a useful antibiotic agent in neonatal infections, and that usually good results can be obtained with intravenous administration 3 times daily with each dose level of 20mg/kg.
