Clinical pharmacology of teicoplanin in infants and children

Teicoplanin is a glycopeptide and is a mixture of related glycopeptides. Teicoplanin inhibits the synthesis of the cell wall in sensitive bacteria by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. Because of its large molecular size, teicoplanin is unable to penetrate the outer membrane of gram-negative bacteria. The intravenous dosage of teicoplanin consists in a loading dose of 16 mg/kg followed by a maintenance dose of 8 mg/kg once-daily to infants aged < one month and in older infants the dosage of teicoplanin consists in a loading dose of 12 mg/kg twice-daily followed by a maintenance dose of 10 mg/kg once daily. In children, the oral dose is 100 to 200 mg twice-daily and the intravenous dosage consists in 12 mg/kg twice-daily followed by 12 mg/kg once-daily. Teicoplanin has been found efficacy and safe in infants and children. The elimination half-life of teicoplanin is 73.9 hours in infants and children and teicoplanin is cleared from the body by renal and extra-renal routes. The total body clearance of teicoplanin is 0.09 L/h in children aged < 12 months and 0.29 L/h in older children. The treatment and the prophylaxis with teicoplanin have been described in infants and children. Teicoplanin administered intravenously and/or intraventricularly treats the cerebral infections caused by staphylococci and enterococci. The aim of this study is to review the published data on teicoplanin dosing, efficacy and safety, pharmacokinetics, drug-interactions, treatment, prophylaxis, and penetrates into the cerebrospinal fluid in infants and children.

Download Full-text

Endoscopic retrograde cholangiopancreatography in infants and children

Endoscopy International Open ◽

10.1055/a-1337-2212 ◽

2021 ◽

Vol 09 (03) ◽

pp. E292-E296

Author(s):

Tone Lise Åvitsland ◽

Lars Aabakken

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Medical Records ◽

Pediatric Patients ◽

Biliary Stricture ◽

Infants And Children ◽

University Hospital ◽

Older Children ◽

Endoscopic Retrograde ◽

Procedure Codes ◽

In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

Download Full-text

Once daily cefixime compared with twice daily trimethoprim/sulfamethoxazole for treatment of urinary tract infection in infants and children

The Pediatric Infectious Disease Journal ◽

10.1097/00006454-199203000-00005 ◽

1992 ◽

Vol 11 (3) ◽

pp. 198-202 ◽

Cited By ~ 20

Author(s):

RON DAGAN ◽

MENACHEM EINHORN ◽

RUTH LANG ◽

AVISHALOM POMERANZ ◽

BARUCH WOLACH ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Infants And Children ◽

Once Daily ◽

In Infants And Children

Download Full-text

CONTACT-TYPE DELAYED HYPERSENSITIVITY IN INFANTS AND CHILDREN: INDUCTION OF RHUS SENSITIVITY

PEDIATRICS ◽

10.1542/peds.27.1.51 ◽

1961 ◽

Vol 27 (1) ◽

pp. 51-53

Author(s):

William L. Epstein

Keyword(s):

Intermediate Position ◽

Infants And Children ◽

Delayed Hypersensitivity ◽

Older Children ◽

Contact Sensitization ◽

Contact Type ◽

Frequency Of Contact ◽

In Infants And Children

The frequency of contact sensitization to a Rhus allergen, pentadecyl catechol, was determined in 102 infants and children 1 month to 8 years of age. Children between 3 and 8 years were readily sensitized and showed a depth of sensitivity and intensity of reaction comparable to that seen in adults. Infants below the age of 1 year had a markedly depressed ability to react to Rhus allergens. Children between 1 and 3 years old assumed an intermediate position, being more reactive than infants, but less so than older children. Theoretically these observations suggest that the mechanism of delayed hypersensitivity matures more slowly than other processes of immunity and resistance. Clinically the findings mean that lack of exposure is a more important factor than lack of susceptibility in explaining the diminished incidence of clinical Rhus sensitivity in children below the age of 8 years.

Download Full-text

Clinical pharmacology of lorazepam in infants and children

Journal of Clinical Case Reports and Studies ◽

10.31579/2690-8808/094 ◽

2022 ◽

Vol 3 (1) ◽

pp. 01-07

Author(s):

Gian Maria Pacifici

Keyword(s):

Breast Milk ◽

Adverse Effects ◽

Human Placenta ◽

Liver Microsomes ◽

Intravenous Dose ◽

Infants And Children ◽

Published Data ◽

Elimination Half ◽

And Migration ◽

In Infants And Children

Lorazepam is a benzodiazepine has antiepileptic activity; it may be administered intravenously, intramuscularly, orally, by intranasal or buccal application and following oral dosing it is well absorbed. In infants, the initial intravenous dose of lorazepam is 100 µg/kg and in children the initial oral and intravenous dose is 50 to 100 µg/kg and the dose varies according to the child age. Lorazepam has been found efficacy and safe in infants and children but it may induce adverse-effects. Lorazepam is a racemate and the R and S enantiomers are conjugated with glucuronic acid in human liver microsomes and the respective Km and Vmax values are 29+8.9 and 36+10 µM and 7.4+1.9 and 10+3.8 pmol/min*mg. Lorazepam interacts with drugs and the interaction may affect the activity or metabolism of lorazepam. The pharmacokinetics of lorazepam have been studied in infants and children and in diseased children. In infants and children the elimination half-life is about 15 hours and it is about 24 hours and about 37 hours in children with severe malaria and convulsions following intravenous and intramuscular administration, respectively. The treatment and trials with lorazepam have been studied in infants and children. Lorazepam freely crosses the human placenta and poorly migrates into the breast-milk. The aim of this study is to review the published data on lorazepam dosing, efficacy and safety, adverse-effects, metabolism, interaction with drugs, pharmacokinetics, treatment and trials in infants and children and the lorazepam transfer across the human placenta and migration into the breast-milk.

Download Full-text

Clinical pharmacology of morphine in infants and children

Pharmaceutics and Pharmacology Research ◽

10.31579/2693-7247/053 ◽

2021 ◽

Vol 4 (5) ◽

pp. 01-08

Author(s):

Gian Maria Pacifici

Keyword(s):

Breast Milk ◽

Adverse Effects ◽

Human Brain ◽

Human Placenta ◽

Rectal Administration ◽

Infants And Children ◽

Published Data ◽

And Migration ◽

Control Pain ◽

In Infants And Children

Morphine is used to treat pain, for treatment of opioid dependence, and neonatal abstinence syndrome. Morphine is modestly absorbed from the gastrointestinal tract whereas after rectal administration, by intranasal or buccal application morphine is well absorbed. Morphine is eliminated by glomerular filtration and by conjugation with glucuronic acid; morphine-3-glucurinide and morphine-6-glucurinide are the main metabolites and the last has analgesic effect. In infants, morphine is used to treat severe or sustained pain, sedation, and pain relief. In children, morphine is used to control pain and morphine may be administered by subcutaneous or intravenous injection, orally, by rectum, or by continuous subcutaneous infusion and morphine dose varies according to the child age. Morphine has been found efficacy and safe in infants and children but may induce adverse-effects. The effects caused by morphine and the treatment with morphine have been studied in infants and children. In newborns, morphine elimination half-life ranges from 7.7 to 13.5 hours and decreases with infant maturation. In newborns, infants and children, the total body clearance of morphine ranges from 14.5 to 71.1 L/h/70kg and increases with infant maturation and child development. Morphine is transported in the human brain, poorly crosses the human placenta and accumulates in breast-milk. The aim of this study is to review the published data on morphine dosing, efficacy and safety, effects, adverse-effects, pharmacokinetics, metabolism, drug interaction, treatment, transport into human brain of infants and children and morphine transfer across the human placenta and migration into the breast-milk.

Download Full-text

Pediatric Pain

Oxford Textbook of Palliative Nursing ◽

10.1093/med/9780190862374.003.0064 ◽

2019 ◽

pp. 773-782

Author(s):

Juliana H. O’Brien ◽

Maggie C. Root

Keyword(s):

Pain Management ◽

Pain Assessment ◽

Developmental Stages ◽

Developmentally Appropriate ◽

Infants And Children ◽

Psychological Consequences ◽

Older Children ◽

Nonverbal Children ◽

In Infants And Children ◽

Experience Pain

Children and infants experience pain as a serious complication of disease and injury, but only recently have clinicians come to understand how children experience pain. Exposure to painful injury is associated with psychological consequences in infants and children, including posttraumatic stress symptoms, neurodevelopmental issues, increased anxiety, and cortical dysfunction in childhood. In seriously ill infants, pain may be associated with increased morbidity and mortality; in older children, untreated pain can lead to decreased functioning, social isolation, sleep disorders, and mood changes. Prevention and relief of pain for this vulnerable population is essential. Pain assessment and management in infants and children require that palliative care nurses understand the developmental stages of childhood. This chapter provides a recommended approach to pain assessment and pain management in children. It outlines age-specific and developmentally appropriate pain assessment tools. It describes commonly observed pain behaviors in verbal and nonverbal children. It highlights the management differences between acute pain, neuropathic pain, and chronic pain. It details a combined nonpharmacologic and pharmacologic (including weight-based dosing) approach for pain management.

Download Full-text