Abstract
The new cephalosporin compounds have increased in vitro activity against gram-negative enteric bacilli and penetrate well into cerobrospinal fluid. Moreover, their pharmacokinetic properties are favorable and their safety seems adequate, although insufficiently evaluated to date. Interest has been focused on them as therapeutic agents for neonatal sepsis and meningitis caused by Enterobacteriaceae. In this review the third generation cephalosporins are evaluated for their possible use in the neonates; opinions are based on currently available data. It is concluded that moxalactam and cefotaxime and probably also ceftriaxone and ceftazidime represent valuable alternatives to aminoglycosides for therapy of severe neonatal infection.
Similar content being viewed by others
References
Anderson EL, Hilligoos DM, Szego E (1982) Pharmacokinetics of cefoperazone in neonates following a single intravenous dose. Curr Chemoth Immunoth (Proc 12th ICC Florence, Italy, 19–24 July, 1981) 1:620–622
Dash CH, Kennedy MRK, Ng SH (1980) Cefuroxime in the first week of life. Curr Chemoth Infect Dis (Proc of the 11th ICC and the 19th ICAAC) II:1161–1162
De Louvois J, Mulhall A, Hurley R (1982) Cefuroxime in the treatment of neonates. Arch Dis Child 57:59–62
Goering RV, Sanders CC, Sanders WE Jr (1982) Antagonism of carbenicillin and cefamandole by cefoxitin in treatment of experimental infections in mice. Antimicrob Agents Chemother 21:963–967
Gooch WM, Eggert L, Dalcourt J, Swenson EO (1983) Neonatal pharmacokinetic properties of ceftazidime, Abstract No 48, Ceftazidime Symposium, 2–4 March 1983, London, England
Kafetzis DA, Brater DC, Kapiki AN, Papas CV, Dellagrammaticas H, Papadatos CJ (1982) Treatment of severe neonatal infection with cefotaxime. Efficacy and pharmacokinetics. J Pediatr 100: 483–389
McCracken GH Jr, Nelson JD (1982) The third generation cephalosporins and the pediatric practitioner. Pediatr Infect Dis 1:123–125
McKee KT, Wright PF, Gregg CR, Stratton CW (1980) Initial evaluation of kinetics and efficacy of moxalactam in neonatal systemic gram-negative bacterial disease. Curr Therap Res 28: 603–610
Neu HC (1982) The new beta-lactamase-stable cephalosporins. Ann Intern Med 97:408–419
Pfenninger J, Schaad UB, Lütschg J, Nussbaumer A, Zellweger U (1982) Cefuroxime in bacterial meningitis. Arch Dis Child 57: 539–543
Sakata Y, Boccazzi A, McCracken GH Jr (1983) Pharmacokinetics and bacteriological effect of ceftazidime in experimental Streptococcus pneumoniae, Haemophilus influenzae, and Escherichia coli meningitis. Antimicrob Agents Chemother 23: 213–217
Sanders CC, Sanders WE Jr, Goering RV (1982) In vitro antagonism of beta-lactam antibiotics by cefoxitin. Antimicrob Agents Chemother 21:968–975
Schaad UB (1983) Indikationen für die Cephalosporine in der Pädiatrie? In: Pädiatrische Infektionskrankheiten III, Pädiatrische Fortbildungskurse für die Praxis, Band 58:89–101 (Karger, Basel)
Schaad UB, McCracken GH Jr (1981) Pharmacologic basis for antimicrobial therapy of neonatal meningitis. Helv Paediatr Acta 36:19–30
Schaad UB, Stoeckel K (1983) Single-dose pharmacokinetics of ceftriaxone in newborn infants. Abstract, XVII International Congress of Pediatrics, 7–12 Nov 1983, Manila, Philippines
Schaad UB, McCracken GH Jr, Threlkeld N, Thomas ML (1981) Clinical evaluation of a new broad-spectrum oxa-beta-lactam antibiotic, moxalactam, in neonates and infants. J Pediatr 98: 129–136
Schaad UB, McCracken GH Jr, Look AC, Thomas ML (1981) Pharmacokinetics and bacteriologic efficacy of moxalactam, cefotaxime, cefoperazone, and rocephin in experimental bacterial meningitis. J Infect Dis 143:156–163
Shelton S, Nelson JD, McCracken GH Jr (1980) In vitro susceptibility of gram-negative bacilli from pediatric patients to moxalactam, cefotaxime, Ro 13-9904, and other cephalosporins. Antimicrob Agents Chemother 18:476–479
Wilkinson PJ, Belohradsky BH, Marget W (1977) A clinical study of cefuroxime in neonates. Proc Roy Soc Med 70 [Suppl 9]:183–187
Author information
Authors and Affiliations
Additional information
Curriculum vitae. Urs B. Schaad was born 1945 in Switzerland. He graduated 1971 from the Medical Faculty of the Bernese University and his postgraduate training included 1 year General Surgery (Lugano), 11/2 years Internal Medicine (Langenthal) and 41/2 years Pediatrics (Berne). From 1978 to 1980 he completed a Research Fellowship in Pediatric Infectious Diseases at the University of Texas at Dallas, USA (Directors of Program: Prof. George H. McCracken, Jr., and Prof. John D. Nelson). Since 1981 he is back at the Department of Pediatrics, University of Berne (Head: Prof. E. Rossi), conducting clinical, research and teaching activities in Pediatric Infectious Diseases. In June 1983 he was promoted to Privatdozent and received the Venia Docendi in Pediatrics with special regard to Infectious Diseases. Main topics of research have been experimental meningitis and studies on pharmacokinetics and efficacy of different antimicrobial agents in pediatric patients. Previous reviews included recrudescence and relapse in bacterial meningitis, atypical myobacterial lymphadenitis, melioidosis, pyogenic sacroiliitis, arthritis in meningococcal disease, infantile chlamydial pneumonia, Campylobacter-reactive arthritis, prophylaxis against pneumococcal, meningococcal and H. influenzae type b infections in childhood, neonatal sepsis and meningitis, and infectious diarrhea in the pediatric age group.
Rights and permissions
About this article
Cite this article
Schaad, U.B. The cephalosporin compounds in severe neonatal infection. Eur J Pediatr 141, 143–146 (1984). https://doi.org/10.1007/BF00443211
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00443211