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Cited by 184Antifungal resistance and susceptibilityPharmaceutical studies and practicesFungal Infections and Studies

The DOI matches its Crossref record; 24 of the 25 references it cites were found in a registry or an index.

Pharmacokinetics, outcome of treatment, and toxic effects of amphotericin B and 5-fluorocytosine in neonates

Baley, Jill E., Meyers, Carolyn, Kliegman, Robert M., Jacobs, Michael R., Blumer, Jeffrey L.·1990·The Journal of Pediatrics
DOI 10.1016/s0022-3476(05)82674-5
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Abstract

To determine the pharmacokinetics of amphotericin B and 5-fluorocytosine in neonates, we measured serum concentrations at first dose and after 5 days of therapy by high-performance liquid chromatography in 13 neonates (mean birth weight 1.2 +/- 0.8 kg). The dose of amphotericin B was serially increased from 0.1 to 0.5 mg/kg/day in 10 infants but was decreased from 0.8 to 1.0 to 0.5 mg/kg/day in three infants. Amphotericin B concentrations were not detectable in infants receiving 0.1 mg/kg/day. Amphotericin B cerebrospinal fluid concentrations were 40% to 90% of serum values obtained simultaneously. Serum concentrations after oral administration of 5-fluorocytosine (dose 25 to 100 mg/kg/day) were detectable in all infants. We found extreme interindividual variability for the half-life, volume of distribution, and clearance for both drugs. Four infants had minimal elimination for both drugs between doses, a finding that correlates with rises in serum creatinine (greater than 0.4 mg/dl, 40 mumol/L) and blood urea nitrogen (greater than 10 mg/dl, 3.6 mmol/L). We recommend that the dose of amphotericin B given on the first day of treatment be greater than the usual testing dose of 0.1 mg/kg/day. We also recommend an initial 24-hour dosing interval for amphotericin B and 5-fluorocytosine. Serum drug concentrations may need to be monitored in high-risk, low birth weight infants.

Overview

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Crossref · 10.1016/s0022-3476(05)82674-5

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Metadata

Authors
Baley, J. E., Meyers, C., Kliegman, R. M., Jacobs, M. R., & Blumer, J. L.
Affiliations
Rainbow Babies & Children's Hospital (US)
Corresponding author
Baley, Jill E.
ORCID
Jacobs, Michael R.
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
1990-05
Volume
116
Issue
5
Pages
791-797
ISSN
0022-3476 (ISSN-L)
DOI
10.1016/s0022-3476(05)82674-5
OpenAlex
W2019367173
Cited by
184
References
25
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 8 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 12 · 2013: 12 · 2012: 8
FWCI
2.16
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
Keywords
amphotericin B, 5-fluorocytosine, neonates, pharmacokinetics, serum drug concentration, cerebrospinal fluid drug concentration, interindividual variability, drug elimination, renal function, low birth weight infants, antifungal therapy, dosing interval, therapeutic drug monitoring
MeSH terms
Amphotericin B, Candidiasis, Flucytosine, Gestational Age, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Kidney, Mycoses, Prognosis

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