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Serial measurements of serum methyprylon concentration were made in the case of a 14-year-old girl who ingested an overdose of the drug. Our data indicate that, in the presence of high plasma levels of the drug, much longer half-lives than the usually reported four hours may be observed. It is postulated that saturation kinetics may be a possible mechanism for this observation. The striking clinical improvement after six hours of hemodialysis demonstrated the efficacy of this mode of treatment in our patient.

Sixty-two children with Haemophilus meningitis were treated with ampicillin sodium, 200 mg/kg/day for ten days. Thirty-one received the drug intravenously (IV) for ten days; the other 31 patients received ampicillin IV for five days (except for one test dose given intramuscularly [IM] on day 2) followed by IM administration of ampicillin the last five days. Ampicillin concentrations in cerebrospinal fluid (SCF) were higher one hour after IV administration, but at two and four hours, concentrations were greater after IM doses. Responses to therapy and rates of complications were similar in the two groups. Fourteen patients had positive CSF cultures on day 2. Ten of these were isolated only on Levinthal medium and would have been overlooked with routine culture methods. All organisms were ampicillin-susceptible and all CSF cultures were negative by 48 hours. More patients with delayed sterilization had neurologic sequelae (78%) than patients with prompt CSF sterilization (13%). The schedule of five days of IV treatment followed by five days of IM therapy was pharmacologically and clinically as effective as ten days of IV therapy and has practical advantages.