Comparative Pharmacokinetics of Amoxicillin and Ampicillin in Infants and Children

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 627-631 ◽  
Author(s):  
Charles M. Ginsburg ◽  
George H. McCracken ◽  
Marion L. Thomas ◽  
Joan Clahsen
Keyword(s):  
Half Life ◽  
Area Under The Curve ◽  
Infants And Children ◽  
Peak Serum ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Serum Concentrations ◽  
Type B ◽  
Group A ◽  
In Infants And Children

The pharmacokinetics of amoxicillin and ampicillin were studied in 24 infants and children. Mean peak serum concentrations of 5.4 µg/ml in fasting and 3.2 µg/ml in nonfasting patients were observed after 15 mg/kg amoxicillin doses. Area under the curve values and serum half-life values were similar in fasting and nonfasting patients. The pharmacokinetics of amoxicillin (15 mg/kg) were compared to those of ampicillin (25 mg/kg). Peak serum concentrations, area under the curve values and half-life times were comparable for the two drugs. Amoxicillin (25 mg/kg) and ampicillin (25 mg/kg) were compared in cross-over fashion in 11 children. Serum concentrations of amoxicillin were consistently larger than those of ampicillin; the differences were of borderline significance at one and two hours and statistically significant at four and six hours after the dosage. The bioavailability of amoxicillin was twice that of ampicillin. Amoxicillin was detected in approximately half of the saliva samples studied. Although the salivary concentrations in many children exceeded the inhibitory level for most pneumococci and group A streptococci and for many non-β lactamase-producing Haemophilus influenzae type b strains, the clinical relevance of these observations is unknown.

Pharmacokinetics of Rifampin in Infants and Children: Relevance to Prophylaxis Against Haemophilus influenzae Type b Disease

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 17-21
Author(s):  
George H. McCracken ◽  
Charles M. Ginsburg ◽  
Teresa C. Zweighaft ◽  
Joan Clahsen
Keyword(s):  
Haemophilus Influenzae ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Epidemiologic Studies ◽  
Infants And Children ◽  
Haemophilus Influenzae Type ◽  
Pharmacokinetic Studies ◽  
Haemophilus Influenzae Type B ◽  
Serum Concentrations ◽  
Type B

Pharmacokinetic studies of rifampin were performed in 38 infants and children after administration of three different oral formulations. Mean peak serum concentrations of from 9 to 11.5 µg/ml were observed one hour after a 10-mg/kg dose and the average half-life was 2.9 hours. Patients who received rifampin suspension in applesauce had smaller serum concentrations and area-under-the-curve values than did those who were given suspension alone. The mixture of rifampin powder and applesauce resulted in more variable serum levels. The concentrations of drug in tears from 18 subjects were similar to those in serum. All but one of 118 saliva specimens obtained from two to eight hours after the 10-mg/kg dose had antimicrobial activity. Of samples taken at two hours, 95% contained rifampin levels that exceeded the minimal bacterial concentration for 15 Haemophilus influenzae type b strains. Bactericidal activity against Haemophilus correlated with salivary rifampin concentrations and was detectable in virtually all specimens containing [Unknown]0.8 µg/ml. These data provide the pharmacokinetic basis for rifampin prophylaxis of close contacts of H influenzae type b disease, but are insufficient alone to recommend routine usage of rifampin for this purpose until results of additional epidemiologic studies are available.

A Comparison of Three Antibiotic Regimens for Eradication of Haemophilus influenzae Type b from the Pharynx of Infants and Children

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 136-138
Author(s):  
Douglas B. Horner ◽  
George H. McCracken ◽  
Charles M. Ginsburg ◽  
Teresa C. Zweighaft
Keyword(s):  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Attack Rate ◽  
Antimicrobial Agents ◽  
Index Case ◽  
Infants And Children ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
In Infants And Children

The communicability of Haemophilus influenzae type b has recently been shown to be comparable to that of Neisseria meningitidis.1,2 The secondary attack rate of H influenzae type b disease is approximately 2% in young contacts of an index case, an observation that has stimulated investigators to attempt to identify effective chemoprophylactic regimens. Elsewhere in this issue are two studies reporting successful use of rifampin in eradicating H influenzae type b from the pharynx of infants and children who were exposed to patients with the disease.3,4 Other regimens have not been effective.5,6 The purpose of this brief communication is to report our results with three antimicrobial agents that were given in an attempt to eliminate pharyngeal carriage of H influenzae type b in infants and children.

Responses of Children Immunized with Capsular Polysaccharide of Hemophilus influenzae Type b, by David H. Smith, MD, et al,Pediatrics, 1973;52:637–644; and Haemophilus influenzae Type b Capsular Polysaccharide Vaccine in Children: A Double-blind Field Study of 100 000 Vaccinees 3 Months to 5 Years of Age in Finland, by Heikki Peltola, MD et al,Pediatrics, 1977;60:730–737

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_1) ◽  
pp. 252-254
Author(s):  
Georges Peter
Keyword(s):  
Capsular Polysaccharide ◽  
Serum Antibody ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Antibody Concentration ◽  
Antigen Binding ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Age Dependent ◽  
Group A

One hundred forty-one children of 5 to 59 months of age were immunized with a single intramuscular dose of 0.67, 3.3, 17, or 67 μg polyribophosphate (PRP), the capsular antigen ofHemophilus influenzae, type b. The immunizations were well tolerated, particularly at doses of .67 to 17 μg. Antibody activity was measured by radioactive antigen binding, using3H-labelled PRP. Doses of 3.3 and 17 μg produced significant antibody rises in nearly 90% of recipients; 0.67 and 67 μg in approximately half. The geometric mean titers were similar at three and six weeks after immunization and were greater with the middle doses. The net antibody increase in responding children was strongly age dependent, but was not related to the preimmunization antibody concentration. Rises in serum bactericidal activity against H. influenzae type b generally accompanied rises in antibody concentration as measured by the antigen-binding assay. A recently developed Haemophilus influenzae type b capsular polysaccharide vaccine was given to 48 977 children 3 months to 5 years of age; an equal number of children receiving group A meningococcal vaccine served as controls. The protection as well as serum antibody response was strongly age dependent. Among children who had received the H. influenzae type b vaccine when 18 months of age or older, there were no cases of bacteremic disease caused by H. influenzaetype b in the first year after vaccination. At the same time 11 such cases were seen in the control group of the same age, a highly significant difference. In the second year after vaccination two cases occurred in the H. influenzae type b-vaccinated group, five in the meningococcal-group A vaccinated group. No protection was seen among children who had been younger than 18 months when vaccinated, even if they received a booster dose of the vaccine. The serum antibody response to the H. influenzae type b polysaccharide, measured by radioimmunoassay, was poor in children below 18 months of age and good in those above it. No effect of the vaccine could be seen on the nasopharyngeal carriage of H. influenzae type b, which was approximately 6% in this age group. Adverse effects of the vaccine were mild.

Interchangeability of Haemophilus influenzae Type b vaccines in the Primary Series: Evaluation of a Two-dose Mixed Regimen

PEDIATRICS ◽  
1996 ◽  
Vol 98 (5) ◽  
pp. 898-904 ◽  
Author(s):  
Kathleen M. Bewley ◽  
Joel G. Schwab ◽  
Gerard A. Ballanco ◽  
Robert S. Daum
Keyword(s):  
Haemophilus Influenzae ◽  
Randomized Clinical Trials ◽  
Geometric Mean ◽  
Serum Antibody ◽  
Area Under The Curve ◽  
Haemophilus Influenzae Type ◽  
Antibody Concentration ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Series Evaluation

Objective. To evaluate two- or threedose "mixed" regimens of Haemophilus influenzae type b conjugate vaccines in the priming series. Design. Two randomized clinical trials with 140 and 181 infants, respectively. Setting. Private practices in New Orleans and Chicago. Methods. In trial I, infants received one of four regimens. Two were recommended regimens for polyribosylribitol phosphate (PRP)—meningococcal protein conjugate (M) and PRP—tetanus toxoid conjugate (T). Two mixed regimens consisted of M at 2 months followed by two doses of T or PRP—diphtheria toxoid conjugate (D) at 4 and 6 months. Trial II consisted of three groups. Two were recommended regimens for M and T. The third was a two-dose mixed regimen consisting of M at 2 months and T at 4 months. Parents were interviewed and instructed to record side effects after each vaccination. Serum was assayed for H influenzae type b anticapsular antibody (anti-PRP). Results. Minor differences in safety profiles likely reflected α error. In trial I, M (lot 0884T, one of several known to have had decreased immunogenicity), probably primed for substantial increase in serum antibody when D or T was given at 4 and 6 months. In trial II, infants who received the two-dose mixed regimen (M from immunogenic lot 0116W at 2 months and T at 4 months) had a significantly higher mean area under the curve than recipients of the three-dose TIT regimen when antibody concentration was plotted against age, although the geometric mean anti-PRP antibody concentration for the MT-recipients was significantly lower at 7 months. Conclusions. M used in trial I may have primed infants despite poor immunogenicity. The two-dose mixed regimen (MT-) in trial II produced a mean anti-PRP antibody concentration with higher sustained anti-PRP concentrations from 2 to 7 months, as judged by the area under the curve, but a lower mean anti-PRP antibody concentration at 7 months.

Isolated Uvulitis Due to Haemophilus influenzae Type b

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1054-1057
Author(s):  
Karl I. Li ◽  
Sharon Kiernan ◽  
Ellen R. Wald ◽  
James S. Reilly
Keyword(s):  
Haemophilus Influenzae ◽  
Streptococcal Pharyngitis ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Lateral Neck ◽  
Type B ◽  
Group A ◽  
Lateral Neck Radiograph

Infections of the uvula are infrequently recognized and have been previously described only in association with group A streptococcal pharyngitis or Haemophilus influenzae type b epiglottitis. Three cases of H influenzae type b bacteremic uvulitis are described. In suspected cases of H influenzae type b uvulitis, a lateral neck radiograph should be performed and parenteral antibiotics initiated.

Sign in / Sign up

Export Citation Format

Share Document