This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fonseca, W. Articles by Qazi, S. Search for Related Content PubMed PubMed Citation Articles by Fonseca, W. Articles by Qazi, S.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, March 2003, p. 997-1001, Vol. 47, No. 3
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.3.997-1001.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Comparing Pharmacokinetics of Amoxicillin Given Twice or Three Times per Day to Children Older than 3 Months with Pneumonia

Walter Fonseca,¹ Kalle Hoppu,^2,3* Luís C. Rey,^4,5 João Amaral,^1,4 and Shamim Qazi⁶

Department of Community Health,¹ University Hospital, Federal University of Ceará,⁵ Albert Sabin Children's Hospital, Fortaleza, Brazil,⁴ Poison Information Centre, Helsinki University Central Hospital,² Department of Pediatrics and Clinical Pharmacology, University of Helsinki, Helsinki, Finland,³ Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland⁶

Received 17 January 2002/ Returned for modification 16 September 2002/ Accepted 19 November 2002

For children with ambulatory pneumonia, the World Health Organization (WHO) recommends oral amoxicillin (15 mg/kg of body weight/dose) thrice daily (t.i.d.) or oral cotrimoxazole (4 mg of trimethoprim/kg/dose) twice daily (b.i.d.). The more frequent amoxicillin dosing may lead to compliance problems. To compare the pharmacokinetics and levels of amoxicillin in plasma in the current WHO acute respiratory infection recommendations with the 25-mg/kg/dose b.i.d. regimen, we performed a two-group parallel study of 66 children ages 3 to 59 months with pneumonia. Amoxicillin was given orally at 25 mg/kg/dose b.i.d. or 15 mg/kg/dose t.i.d. Amoxicillin concentrations were determined by high-performance liquid chromatography after the first dose on days 1 and 3. After the first dose on day 1, the mean area under the concentration-time curve (AUC) for amoxicillin after the 25-mg/kg dose was 54.7 versus 24.9 µg · h/ml after the 15-mg/kg dose. After the first dose on day 3, the mean AUC was 44.1 versus 28.5 µg · h/ml. All but two children had plasma amoxicillin concentrations above 0.5 µg/ml for >50% of the dose interval on both days. Six children on day 1 and five children on day 3 had concentrations above 1.0 µg/ml for <50% of the dose interval. On day 1, 16 of 27 children in the b.i.d. group and 11 of 26 children in the t.i.d. group had concentrations that were above 2.0 µg/ml for <50% of the dose interval, and on day 3, 18 of 31 children in the b.i.d. group and 8 of 31 children in the t.i.d. group had concentrations that were above 2.0 µg/ml for <50% of the dose interval. Amoxicillin b.i.d. is a feasible alternative for t.i.d. dosing. To lengthen the time above the MIC at higher concentration levels, a 30- to 40-mg/kg/dose b.i.d. should be considered instead of the 25 mg/kg/dose used in this study.

---

* Corresponding author. Mailing address: Poison Information Centre, Helsinki University Central Hospital, P.O. Box 340 (Haartmaninkatu 4), FIN-00029 HUS (Helsinki), Finland. Phone: 358-9-471 74 788. Fax: 358-9-471 74 702. E-mail: kalle.hoppu{at}hus.fi.

---

Antimicrobial Agents and Chemotherapy, March 2003, p. 997-1001, Vol. 47, No. 3
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.3.997-1001.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.