Naslov
Use of antibiotics in neonatal patients – challenges and new approaches

Autori
Butković, Ivan ; Klašterka, Klara ; Tomić, Ivan ; Pavliček, Karla ; Šavorić, Juraj ; Maćešić, Nino ; Samardžija, Marko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Book of Abstracts and Conference Proceedings - 2nd International Conference: Antimicrobial resistance in veterinary medicine - current state and perspectives / - : Poljoprivredni fakultet Univerziteta u Novom Sadu, 2023, 26-27

ISBN
978-86-7520-587-6

Skup
2nd International Conference: Antimicrobial resistance in veterinary medicine - current state and perspectives

Mjesto i datum
Novi Sad, Srbija, 22.06.2023. - 24.06.2023

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
neonatologija, antibiotici, farmakokinetika
(neonatology, antibiotics, pharmacokinetics)

Sažetak
The treatment of neonatal patients presents many challenges to veterinarians because the assumption that such patients are only a "small" version of adults is completely wrong because the neonatal period is a dynamic period with numerous factors that affect the pharmacokinetics of drugs and unwanted side effects. Various physiological processes that rapidly change it in the earliest phase of life can affect the effectiveness and safety of antimicrobial therapy, and the biggest obstacle in clinical terms is limited information about such therapy for this critical period. The first month of the cubs' life is also microbiologically very variable and changeable, because each organism develops its own extremely complex microbiota. The influence of pharmacokinetic properties such as half-life, bioavailability and volume of distribution can affect the potential of effectiveness as well as the risks of unwanted side effects. After the application of antimicrobial preparations, such substances must be distributed into the bloodstream. Neonatal patients can be unpredictable and different in distribution of drugs compared to adult animals. In the first 24 hours of life, absorption can be surprisingly very high leading to unexpected and unwanted drug bioavailability. Also, breast-feeding can affect the absorption of some drugs, due to special link of drugs with to certain components of milk. A higher pH of the stomach in neonatal patients can decrease in the percentage of absorption of drugs that have acids in their composition. Subcutaneous drug administration most likely results in equivalent drug levels as intravenous or oral administration, but with variable factors such as hydration status and perfusion, which are compromised in most neonatal patients. After absorption, the antimicrobial preparations are distributed through the serum to the target tissues. Considering that non-natal patients have a higher proportion of extracellular fluid and a lower percentage of fatty tissue, there is an increased distribution of water-soluble drugs (eg penicillin, cephalosporin, aminoglycoside) and lower levels in the tissue. Metabolism can also be affected by lower levels of enzymes involved in drug metabolism in the liver, particularly in the first four weeks of life. The kidneys are the site of elimination of many drugs, and renal excretion is influenced by glomerular filtration rate and renal tubular transport mechanisms, which change over time. Given that kidney and liver function approximates that of an adult at 4 to 6 weeks of age, there is a risk of toxicity such as chloramphenicol, which relies almost entirely on liver metabolism. Antimicrobial preparations are potentially life-saving drugs, but their harmful effects must not be ignored due to their long-term effects on the development of the organism. Correct and effective use of antimicrobials in neonatal patients is complicated by a lack of data, so assumptions about dosing must be made. Above all, efforts should be made to optimize maternal and newborn health to reduce the need for antimicrobials, removing issues of unsafe dosing and long-term effects.

Izvorni jezik
Engleski

Znanstvena područja
Veterinarska medicina

POVEZANOST RADA