Background:This study aimed to evaluate the accuracy and reliability of lung ultrasound (LUS) for diagnosing transient tachypnea of the newborn (TTN) through a meta-analysis. Methods:Relevant studies were retrieved from PubMed, Web of Science, the Cochrane Library, Ovid, Scopus, and Embase databases without restrictions on language or publication date, up to December 31, 2025. Studies evaluating the diagnostic performance of LUS for TTN were included. Two researchers independently extracted data and assessed study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Statistical analyses were performed using Meta-DiSc 1.4, Stata 18.0 and RevMan 5.4 software. Results:Ten studies comprising 1,747 newborns were included in the analysis. The overall methodological quality of the included studies was moderate to high. Threshold analysis indicated no threshold effect. The pooled sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of LUS for diagnosing TTN were 0.93 (95% confidence interval [CI]: 0.78-0.98), 0.99 (95% CI: 0.97-1.00), 81.64 (95% CI: 26.19-254.45), and 0.07 (95% CI: 0.02-0.24), respectively. The pooled diagnostic odds ratio (DOR) was 1113.94 (95% CI: 143.77-8631.13), and the area under the curve (AUC) was 0.97. Meta-regression demonstrated that LUS exhibited significant diagnostic accuracy for TTN. Conclusion:LUS is a promising modality for diagnosing TTN; however, its diagnostic accuracy varies considerably depending on study design and diagnostic criteria. Further studies are warranted to validate the utility of LUS in the diagnosis of TTN.

Although previous studies showed toxicity of brominated flame retardants (BFRs) in human kidney cells in vitro, less is known about actual effects of BFRs exposure on kidney impairment. This study aims to examine associations of joint exposure to multiple BFRs with kidney impairment risk among adults, and with all-cause mortality risk among kidney impairment adults. Information on study participants and their serum concentrations of eleven BFRs (ten PBDEs and one PBB) were obtained from NHANES 2003-2004 and National Death Index. Factor analysis was applied to identify BFR exposure patterns. Data were analyzed using weighted multivariate logistic and Cox proportional regressions to examine the associations of BFR exposure patterns with kidney impairment risk and with all-cause mortality risk, respectively. Results showed concentrations of PBDE-28, PBDE-47, PBDE-85, PBDE-100, PBDE-154 and PBDE-66 among participants with kidney impairment were significantly higher than those without kidney impairment (all p < 0.050). Three exposure patterns were identified under an eigenvalue of ≥ 1.0 (p of Bartlett's test: <0.001; KMO value: 0.787), and one pattern of them, which was characterized by high exposure to PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-154 and PBDE-66, was positively associated with kidney impairment risk (weighted covariates-adjusted OR: 1.317; 95 % CI: 1.031-1.683). The median of follow-up period was 190.0 months. All patterns were not significantly associated with all-cause mortality risk during the follow-up period (all p > 0.050). In conclusion, this study found for the first time that high exposure to some PBDEs may increase kidney impairment risk, but not directly affect prognosis of kidney impairment among adult population.

The full text of this preprint has been withdrawn by the authors in order to comply with an institutional policy on preprints. Therefore, the authors do not wish this work to be cited as a reference.

Purpose: To investigate the molecular characteristics and potential mechanisms underlying the immune-protective effect of Bacillus Calmette-Guerin (BCG) against neonatal sepsis (NS). Methods: Data on transcriptome sequencing of BCG infection, NS, post-BCG infection sepsis, and the respective controls were retrieved from public databases. Systems biology screening was used to identify differentially expressed genes (DEGs) amongst the groups, and common DEGs with high connectivity were selected using protein-protein interaction network analysis. Results: A total of 15 common DEGs were related to the expressions of macrophages and neutrophils after BCG infection and NS infection. Some of the genes were involved in IL-4/IL-13 signal pathway and neutrophil degranulation pathway, and they were highly correlated with the expressions of TNF-alpha, IL-6 and type I interferon-response signal pathway. This may reduce the poor prognosis of NS after BCG infection. Conclusion: These findings provide insights into how BCG-induced trained immunity may provide protection against NS.

Background and Purpose: Vitamin D can both stimulate and inhibit adipogenesis, indicating that associations of the vitamin D level with some metabolic disorders may be nonlinear. This cross-sectional study aims to explore potential nonlinear associations of the 25-hydroxy vitamin D [25(OH)D] level with metabolic syndrome (MetS) and its components. Methods: Adults without previously diagnosed specific noncommunicable disease were selected from the National Health and Nutrition Examination Survey 2017-2018 (n = 870). Their demographic, physical, and laboratory data were obtained. The associations of serum 25(OH)D with MetS and its components were analyzed using logistic regression. Restricted cubic spline was applied to flexibly model the nonlinear association if the nonlinearity test was statistically significant. Results: The 25(OH)D level was inversely associated with risk of MetS [adjusted odds ratio (OR) = 0.986; 95% confidence interval (CI) = 0.978-0.993] and most MetS components, but not with the risk of raised triglycerides (adjusted OR = 0.996; 95% CI = 0.988-1.005). The association of serum 25(OH)D with central obesity risk was significantly nonlinear (P for the nonlinearity test: 0.037). The OR for risk of central obesity decreased rapidly with increase in serum 25(OH)D concentration until the concentration reached 50 nmol/L, and then, the intensity of decrease in OR slowed down. Conclusions: Vitamin D is inversely associated with MetS, but not all MetS components. A nonlinear association between the vitamin D level and risk of central obesity has been found for the first time among the adult population, which reflects the complex roles of vitamin D in lipid metabolism. Although vitamin D deficiency (<50 nmol/L) was defined to avoid abnormal calcium and phosphorus metabolism, preventing its deficiency may also be beneficial for reduction of central obesity risk.

Objective:To establish a risk prediction model for the occurrence of low 1 min Apgar scores in extremely premature infants (EPIs).Methods:From January 2017 to December 2021, EPIs delivered at our hospital were retrospectively analyzed and randomly assigned into training set group and validation set group in a 7∶3 ratio. 17 clinical indicators were selected as predictive variables and low Apgar scores after birth as outcome variables. Lasso regression and multi-factor logistic regression were used within the training set group to select the final predictors for the final model, and the calibration, distinguishability and clinical decision making curves of the final model were evaluated in the validation set group.Results:A total of 169 EPIs were enrolled, including 117 in the training set group and 52 in the validation set group. 4 indicators including gender, fetal distress, assisted conception and delivery time were selected as the final predictors in the final model. Both the training set group and the validation set group had good calibration curves. The area under the receiver operating characteristic curve (AUC) of the prediction model was 0.731, the sensitivity was 72.2%, the specificity was 60.5% and the AUC of the external validation curve was 0.704. The clinical decision making curve showed that the model had a greater benefit in predicting the occurrence of low Apgar score in EPIs within the threshold of 2% to 75%.Conclusions:The clinical prediction model established in this study has good distinguishability, calibration and clinical accessibility and can be used as a reference tool to predict low Apgar scores in EPIs.

The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with the goal to optimize meropenem dosing regimens for LOS therapy. An opportunistic sampling strategy was used to collect meropenem samples, followed by model building and validation. A Monte Carlo simulation was performed to show the probability of target attainment (PTA) for various dosages. The information from 78 newborns (postmenstrual age: 27.4–46.1 weeks) was compiled and had a good fit to a 1-compartment model that had first order elimination. The median (range) values of estimated weight–normalized volume of distribution (V)and clearance (CL) were 0.60 (0.51–0.69) L/kg and 0.16 (0.04–0.51) L/h/kg, respectively. Covariate analysis revealed that postnatal age (PNA), gestational age (GA) and current weight (CW) were the most important factors in describing meropenem PK. Simulation results showed for LOS with a minimal inhibitory concentration (MIC) of 8 mg/L, the doses of 30 mg/kg 3 times daily (TID) as a 1-h infusion for newborns with GA ≤ 37 weeks and 40 mg/kg TID as a 3-h infusion for those with GA > 37 weeks were optimal, with PTA of 71.71% and 75.08%, respectively. In conclusion, we proposed an evidence-based dosing regimen of meropenem for LOS in Chinese newborns by using the population pharmacokinetic–pharmacodynamic analysis, based on domestic common pathogens and their susceptibility patterns.

目的:探讨延长哌拉西林钠他唑巴坦输注时间在早产儿宫内感染治疗中的合理性.方法:参考哌拉西林钠他唑巴坦对敏感菌的最低抑菌浓度(MIC)的敏感折点,适当扩大MIC范围至32 mg/L.结合该药在早产儿宫内感染治疗中的给药剂量、频次及给药时间,制定给药方案.运用群体药动学/药效学模型和蒙特卡洛模拟10000例"真实患者"的获得目标概率(PTA).同一给药方案5种输注时间,针对所有MIC可组成10组对子,通过配对资料考察输注时间对PTA的影响.结果:不同给药方案中,哌拉西林钠他唑巴坦均存在MIC临界值.MIC<临界值时,延长该药输注时间并不能有效增加其PTA;MIC>临界值时,延长输注时间可增加该药的PTA.对于MIC<临界值的分离菌株,同一给药方案,不同输注时间的PTA比较,差异均无统计学意义(P>0.05).结论:对于早产儿宫内感染,延长哌拉西林钠他唑巴坦输注时间并非对所有菌株均适合.对于MIC>临界值(16 mg/L)的分离菌株,更适合延长输注时间;对于MIC<临界值(16 mg/L)的分离菌株,延长输注时间给药方案与传统输注时间给药方案的药效相似.

目的 评价哌拉西林钠/他唑巴坦在新生儿脓毒血症中的给药策略及效果,为临床制定合理治疗方案提供参考.方法 基于药动学/药效学(pharmacokinetics/Pharmacodynamics,PK/PD)理论,应用蒙特卡洛模拟,分别以血药浓度高于4倍最低抑菌浓度(Minimal inhibit concentration,MIC)的时间(100％T>4MIC)和血药浓度高于MIC的时间(100％T>MIC)为PK/PD目标指数,结合新生儿脓毒血症常见细菌为目标菌群,分别对哌拉西林钠/他唑巴坦100 mg/kg Q8h不同静脉滴注时间的给药方案进行模拟,在给药后8 h内每个小时对抗各目标菌群达到PK/PD指数的累积反应分数(Cumulative fraction of response,CFR),以CFR≥90％来判断给药效果.结果 以100％T>4MIC为目标指数,哌拉西林钠/他唑巴坦100 mg/kg Q8h静脉滴注30 min方案,对大肠埃希菌在给药2 h后不能达到CFR≥90％,对肺炎克雷伯菌在给药1 h后不能达到CFR≥90％,对其他目标菌群,在给药后8h内的任意时间点均无法达标;静脉滴注至1h的给药方案相比之前的给药方案仅提高了肺炎克雷伯菌在给药后2 h内的CFR,对其他目标菌群结果没有发生改变;延长静脉滴注方案至3 h,所有目标菌群的CFR均较前方案有所提升,其中对大肠埃希菌在给药后2 h内CFR仍可高于90％.若以100％T>MIC为目标指数,哌拉西林钠/他唑巴坦100 mg/kg Q8h静脉滴注30 min,对大肠埃希菌在给药4 h后不能达到CFR≥90％,对肺炎克雷伯菌在给药2 h后不能达到CFR≥90％,对其他目标菌群,在给药后8 h内的任意时间点均无法达标;静脉滴注至1 h的给药方案相比之前的给药方案对所有目标菌群的CFR均未发生改变;延长静脉滴注方案至3 h,所有目标菌群的CFR均较前方案有所提升,其中对大肠埃希菌、肺炎克雷伯菌在给药后3 h内CFR仍可高于90％.结论 在现有的药物敏感数据下,哌拉西林钠/他唑巴坦在新生儿脓毒血症治疗中仍可作为首选,但目前100 mg/kg Q8 h,静脉滴注30 min或1 h的给药方案值得商榷,静脉滴注延长至3h可显著提高治疗效果,需要时可结合临床及时调整治疗方案.

目的 应用蒙特卡罗模拟优化哌拉西林他唑巴坦在新生儿细菌感染性疾病中的初始给药方案,为临床合理制定方案提供参考.方法 回顾性分析2021年1—4月于首都医科大学附属北京妇产医院新生儿重症监护病房住院应用哌拉西林他唑巴坦治疗的新生儿细菌感染性疾病患儿的临床资料.依据注射用哌拉西林钠他唑巴坦钠的药物说明书,制定18种不同初始给药方案,结合对敏感菌的最小抑菌浓度(MIC)的敏感折点,运用蒙特卡罗模拟分析不同给药方案的目标获得概率(PTA).所有患儿均采用注射用哌拉西林钠他唑巴坦钠100 mg/kg、每8小时1次静脉滴注1 h的给药方案,拟定疗程为7～14 d.分析治疗期间患儿临床资料、辅助检查及治疗效果.结果 蒙特卡罗模拟结果显示,当MIC=0.25 mg/L时,所有给药方案PTA>90％;当MIC=2 mg/L时,除所有每12小时1次给药方案外,其余给药方案PTA>90％;当MIC=16 mg/L时,当前制定的给药方案均不能满足PTA>90％.本研究共纳入33例患儿,其中新生儿宫内感染9例、新生儿肺炎24例.治疗后临床评估有效为33例,症状缓解时间为(1.2±0.6)d,新生儿白细胞计数、中性粒细胞百分比、C反应蛋白、血肌酐水平较治疗前均明显降低(均P<0.001),血小板计数、丙氨酸转氨酶水平与治疗前比较差异均无统计学意义(均P>0.05).结论 蒙特卡罗模拟结果显示哌拉西林他唑巴坦在新生儿细菌感染性疾病的初始给药方案应为100 mg/kg、每8小时1次静脉滴注1 h.临床应用结果表明,该给药方案针对敏感细菌治疗有效,且未见明显不良反应.

Amoxicillin, a broad-spectrum β-lactam antibiotic, is widely used for treatment of neonatal infections. Despite the unmet need in neonates, an adapted analytical method is still missing in clinical practice. The purpose of this study was to develop and test an easy and credible high performance liquid chromatography–UV (HPLC–UV) method to determine amoxicillin in small volumes of human plasma and use it in routine therapeutic drug monitoring (TDM) of neonates. After a protein precipitation, amoxicillin for standards, quality control samples, and patient samples were separated by LC and measured by UV detection, and tinidazole was used as the internal standard. The calibration range was 0.50–20.0 μg/mL. Intra- and inter-day precisions were less than 4.7%. The acceptance criteria of accuracy (between 85–115%) were met in all cases. A plasma volume of 50 μL was required to achieve the limit of quantification of 0.50 μg/mL. Thus, a simple, rapid, and accurate HPLC–UV method has been developed to detect the concentration of amoxicillin in human plasma. This method was adapted to do TDM of amoxicillin in neonates.

目的 总结早产儿真菌败血症的临床特点、有效诊断及治疗方法.方法 回顾性分析22例真菌败血症早产儿的临床资料.结果 早产儿真菌败血症发病时间为生后2～39 d;临床症状表现为发热16例、呼吸暂停16例、血氧波动18例、心率增快15例、腹胀5例、末梢循环欠佳15例;出现血小板减少13例,C反应蛋白增高14例.血培养结果为白色念珠菌6例,近平滑念珠菌16例.治疗首选氟康唑22例,加用两性霉素B脂质体治疗3例,根据药敏结果调整用药2例.结论 旱产儿真菌败血症临床表现无特异性,血培养真菌培养阳性为诊断真菌败血症的金标准,病原菌主要为白色念珠菌和近平滑念珠菌,氟康唑为治疗真菌败血症的首选药物.

Early‐onset sepsis (EOS) is one of the most significant causes of morbidity and mortality in neonates. Currently, amoxicillin is empirically used to treat neonates with EOS. However, data on its effectiveness in neonates with EOS are still limited. Therefore, we aimed to evaluate the pharmacodynamics (PD) target attainment and effectiveness of a model‐based amoxicillin dosage regimen in these neonates. We used a previously developed model and collected additional clinical data from the EOS neonates who used the model‐based dosage regimen (25 mg/kg every 12 h). The primary outcomes were PD target attainment (free drug concentration above minimum inhibitory concentration during 70% of the dosing interval) and treatment failure rate. The secondary endpoints were length of amoxicillin treatment, duration of hospitalization etc. Seventy‐five neonates (postmenstrual age 28.4–41.6 wk) were enrolled. A total of 70 (93.3%) neonates reached their PD target using 1 mg/L as the minimum inhibitory concentration breakpoint. The treatment failure rate was 10.7%.

感染性疾病是我国新生儿的常见疾病,是引起新生儿死亡的重要原因之一.抗生素是新生儿感染性疾病主要的治疗方法.抗生素的超剂量或低剂量使用可导致部分细菌耐药,甚至发生真菌、耐药菌的过度生长.因此,抗生素剂量的个体化应用非常重要.群体药代动力学为新生儿抗生素剂量的选择及开展个体化治疗提供了有力的支持,本文对新生儿感染性疾病抗生素种类的选择及个体化治疗进行总结.

目的:通过应用蒙特卡罗模拟,监测新生儿革兰阳性球菌晚发型败血症药敏试验中最小抑菌浓度(MIC)的变化情况,通过计算累计反应分数(cumulative fraction of response,CFR)评价本中心细菌万古霉素耐药性的变化趋势,分析其潜在诱导细菌耐药性的可能,从而在临床工作中降低细菌耐药的发生.方法:本研究回顾性调查2016年至2019年间北京妇产医院新生儿重症监护病房中新生儿革兰阳性球菌晚发型败血症患儿的基本信息、病原菌种类及药敏结果,按年份分为4组,应用水晶球软件进行蒙特卡罗模拟计算每年敏感抗生素(万古霉素)对革兰阳性球菌的CFR.结果:2016年至2019年新生儿革兰阳性球菌晚发型败血症共58例,每年病原菌检出的数量无明显变化趋势,每年发病人群无统计学差异;其中检出数量最多的病原菌前三位分别为表皮葡萄球菌31株(53.5％),屎肠球菌9株(15.5％)和粪肠球菌6株(10.3％);药敏试验显示表皮葡萄球菌、屎肠球菌和粪肠球菌对万古霉素、利奈唑胺耐药率均为0％;利用蒙特卡罗模拟法计算2016年至2019年期间万古霉素对革兰阳性球菌的CFR分别为82％、88.72％、81.73％、78.53％,整体变化呈下降趋势.结论:应用蒙特卡罗模拟法以药敏试验为标准,通过CFR即可反映细菌耐药性的变化,同时对目前治疗方案给予评价,临床应予以重视.

Early-onset neonatal sepsis (EONS), a bacterial infection that occurs within 72 h after birth, is associated with high likelihood of neonatal mortality. Latamoxef, a semi-synthetic oxacephem antibiotic developed in 1980s, has been brought back into empirical EONS treatment in recent years. In the preliminary work, we established a population pharmacokinetics (PPK) model for latamoxef in Chinese neonates. Moreover, in order to better guide clinical treatment, we conducted dose simulation and found that ascending administration frequency could improve the target rate of 70% of patients having a free antimicrobial drug concentration exceeding the MIC during 70% of the dosing interval (70% fT > MIC). Accordingly, this study is aimed to compare the 70% fT > MIC, efficacy and safety between conventional regimen and PPK model regimen for rational use of latamoxef in EONS treatment. A single-blind, multicenter randomized controlled trial (RCT) for latamoxef will be conducted in Chinese EONS patients. Neonates (≤3 days of age, expected number = 114) admitted to the hospital with the diagnosis of EONS and fulfilling inclusion and exclusion criteria will be randomized (ratio of 1:1) to either a conventional regimen (30 mg/kg q12h) or model regimen (20 mg/kg q8h) latamoxef treatment group for at least 3 days. Primary outcome measure will be 70% fT > MIC and secondary outcome indicators will be the latamoxef treatment failure, duration of antibiotic therapy, changes of white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT), blood culture results during administration and incidence of adverse event (AE)s. Assessments will be made at baseline, initial stage of latamoxef treatment (18–72 h) and before the end of latamoxef treatment. Ethical approval of our clinical trial has been granted by the ethics committee of the Beijing Children’s Hospital (ID: 2020-13-1). Written informed consent will be obtained from the parents of the participants. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR 2000040064).It is hoped that our study will provide a clinical basis for the rational clinical use of latamoxef in EONS treatment.

Background Population pharmacokinetic evaluations have been widely used in neonatal pharmacokinetic studies, while machine learning has become a popular approach to solving complex problems in the current era of big data. Objective The aim of this proof-of-concept study was to evaluate whether combining population pharmacokinetic and machine learning approaches could provide a more accurate prediction of the clearance of renally eliminated drugs in individual neonates. Methods Six drugs that are primarily eliminated by the kidneys were selected (vancomycin, latamoxef, cefepime, azlocillin, ceftazidime, and amoxicillin) as ‘proof of concept’ compounds. Individual estimates of clearance obtained from population pharmacokinetic models were used as reference clearances, and diverse machine learning methods and nested cross-validation were adopted and evaluated against these reference clearances. The predictive performance of these combined methods was compared with the performance of two other predictive methods: a covariate-based maturation model and a postmenstrual age and body weight scaling model. Relative error was used to evaluate the different methods. Results The extra tree regressor was selected as the best-fit machine learning method. Using the combined method, more than 95% of predictions for all six drugs had a relative error of < 50% and the mean relative error was reduced by an average of 44.3% and 71.3% compared with the other two predictive methods. Conclusion A combined population pharmacokinetic and machine learning approach provided improved predictions of individual clearances of renally cleared drugs in neonates. For a new patient treated in clinical practice, individual clearance can be predicted a priori using our model code combined with demographic data.

BACKGROUND:This study aims to investigate the preventive effects of caffeine citrate on cytokine profile and bronchopulmonary dysplasia (BPD) in preterm infants with apnea.METHODS:Preterm infants with apnea who were born at less than 32 weeks of gestational age and birth weight ≤1500 g were randomly divided into caffeine citrate prevention group and caffeine citrate treatment group. Preterm infants in caffeine citrate prevention group who were at risk of developing recurrent apnea were given to caffeine citrate within 8 h after birth. Those in caffeine citrate treatment group experienced apnea after birth were given to caffeine citrate for treatment. Preterm infants in both groups were treated with the same respiratory management and other conventional therapy. After drug discontinuation, levels of cytokine profile, and incidence of BPD were compared between two groups.RESULTS:A total of 56 preterm infants were enrolled. Differences in gestational age (P=0.11) and birth weight (P=0.251) were not statistically significant. Differences in application time of caffeine citrate (P=0.356), hour of ventilator use (P=0.152), length of stay (P=0.416) and BPD morbidity (P=1.00) between two groups were not statistically significant. At birth, there were no statistically significant in levels of IL-6 (P=0.063) and IL-8 (P=0.125) between two groups. After conventional therapy, levels of IL-6 (P=0.001) and IL-8 (P=0.001) significantly decreased in caffeine citrate prevention group compared with those in caffeine citrate treatment group.CONCLUSIONS:Prevention usage of caffeine citrate in preterm infants with apnea could reduce the level of cytokine profile and the incidence of BPD.

ObjectiveCefepime is used to treat severe infections in neonates. Pharmacokinetic data have only been evaluated among preterm neonates and population pharmacokinetic model lacked external validation. Hence, our aim is to obtain the population pharmacokinetic parameters of cefepime with large sampling and optimize the cefepime dosage regimen for neonatal infection based on developmental pharmacokinetics–pharmacodynamics.MethodsBlood samples from neonates and young infants treated with cefepime were collected using the opportunistic sampling design. The concentration of cefepime was determined using high performance liquid chromatography with ultraviolet detection. The population pharmacokinetic model was established using NONMEM software.ResultsOne hundred blood samples from eighty-five neonates were analyzed. The population pharmacokinetics of cefepime were described by a one-compartment model with first-order elimination. Covariate analysis indicated that serum creatinine concentration, postmenstrual age and current weight had significant impact on the pharmacokinetic parameters of cefepime. Monte Carlo simulation results showed that the current dosage regimen (30 mg/kg, q12 h) had a high risk of insufficient dose. For 70% of neonates to obtain a higher free drug concentration than the minimum inhibitory concentration during 70% of the dosing interval, 50 mg/kg q12 h was needed with a susceptibility breakpoint of 4 mg/l. For a minimum inhibitory concentration of 8 mg/l, 40 mg/kg q8 h was recommended for all neonates.ConclusionA population pharmacokinetic model of cefepime in neonates and young infants was established. According to simulation results based on the developmental pharmacokinetics–pharmacodynamics, different dosage regimens should be given depending on pathogens and the postmenstrual age.

Objective To explore the therapeutic effect of latamoxef on neonatal infection using population pharmacokinetics. Methods Eighty-four cases of neonatal infectious diseases treated with latamoxef in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2016 to January 2017 were enrolled; 38 cases were full-term and 46 cases were premature. Latamoxef 30 mg /kg was intravenously administered at intervals of 12 h; the course of treatment was 7-14 d. Clinical data,auxiliary examinations and therapeutic effect were analyzed. Efficacy of latamoxef was evaluated using population pharmacokinetic method. Results The half life of latamoxef was approximately 2.95 h. Leukocyte count after medication significantly decreased compared to that before treatment in full-term infants[(12 ± 6) × 109 /L vs (18 ± 8) × 109 /L](P = 0.011) but showed no significant changes in premature babies[(11 ± 4) × 109 /L vs (11 ± 4) × 109 /L](P = 0.396). Blood level of C-reactive protein dropped to normal(< 10 mg /L) on the 5th day and it was significantly lower than that 1 d after treatment[full-term infants: (1.3 ± 0.6) mg /L vs (15.1 ± 13.2) mg /L; preterm infants: (1.7 ± 1.0) mg /L vs (18.4 ± 15.6) mg /L](both P < 0.001). There was no skin rash,diarrhea,liver and kidney function damage during treatment. No obvious bleeding was observed. Conclusion Clinical application of latamoxef 30 mg /kg every 12 h is effective in both full-term and preterm infants suffering from infection caused by sensitive bacteria; the half life of latamoxef is 2.95 h; no obvious adverse reactions is noticed.