ABSTRACT
The history of drug therapy shows that newborn infants are more prone to adverse reactions to medicines. In 1956, Silverman et al. [1] reported an excessive mortality rate and an increased incidence of kernicterus among preterm neonates receiving a sulphonamide antibiotic as compared to neonates receiving chlortetracycline. Then, in 1959, Sutherland [2] described a syndrome of cardiovascular collapse in newborns receiving high doses of chloramphenicol for presumed infections. More recently, the therapeutic misadventures experienced by low birth weight infants exposed to a parenteral vitamin E formulation [3] and the “gasping syndrome” by infants who received excessive amount of benzyl alcohol [4,5] underscore the persistence of problems with the use of medicines in neonates. As a result of these experiences, neonatologists and paediatricians have recognised that rational drug therapy for neonates is often confounded by a combination of unpredictable and often poorly understood pharmacokinetic and pharmacodynamic interactions [6–9].
