PEDIATRICS Vol. 75 No. 2 February 1985, pp. 294-298
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Potential of Moxalactam and Other New Antimicrobial Agents for Bilirubin-Albumin Displacement in Neonates

Harris R. Stutman MD1, K. Michael Parker PhD1, and Melvin I. Marks MD1

1 From the Departments of Pediatrics and Pathology, University of Oklahoma Health Sciences Center, Oklahoma Children's Memorial Hospital, Oklahoma City

The effects of several novel antibiotics on in vitro binding of bilirubin to human serum albumin were investigated. At physiologic bilirubin-albumin ratios and pH values, aztreonam, imipenem, azlocillin, enoxacin and ciprofloxacin did not compete with bilirubin at drug concentrations less than 900 µg/mL. Cefoperazone caused an apparent increase in unbound bilirubin only at concentrations greater than 35 µM (330 µg/mL). Moxalactam, however, caused a linear increase in unbound bilirubin, greater than that seen with sulfisoxazole, over the entire range of antibiotic concentrations. These results may have implications for the use of these newer antimicrobial agents in neonatal infections.

Key Words: antimicrobial agents • bilirubin • binding • moxalactam • neonate

Submitted on December 9, 1983
Accepted on April 3, 1984