Theophylline toxicity in term infants
F. E. Simons, F. R. Friesen and K. J. Simons
The pharmacokinetics of theophylline were studied in 1-month-old term
infants who received accidental overdoses of theophylline during treatment
for bronchiolitis. Both infants survived without neurologic sequelae.
Elimination half-life values of 14.5 and 15.2 hours, respectively, were
shorter than reported in premature infants but longer than in infants aged
3 months or older. Caffeine appeared in the sera of both patients, who had
not received it in any form. In term infants, elimination of theophylline
may occur by N-methylation in contrast to older patients in whom the drug
is chiefly eliminated by demethylation and oxidation. Theophylline has not
been proved effective for the treatment of bronchiolitis. It should be used
with caution for wheezing in very young infants until its pharmacokinetics
have been studied further in nontoxic, full-term infants younger than age 3
months.
