Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity

• Published in: Journal of Perinatology Vol. 27; no. 11; pp. 709 - 712
• Main Authors: Chereches-Panta, P, Nanulescu, M V, Culea, M, Palibroda, N
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.11.2007
• Subjects: Aminophylline; Aminophylline - pharmacokinetics; Aminophylline - therapeutic use; Apnea; Apnea - blood; Apnea - drug therapy; Bronchodilator Agents - pharmacokinetics; Bronchodilator Agents - therapeutic use; Dosage and administration; Drug dosages; Drug Monitoring; Drug therapy; Female; Health aspects; Humans; Infant; Infant, Newborn; Infants; Infusions, Intravenous; Male; Metabolism; Monitoring; Newborn babies; Pediatrics; Reliability analysis; Respiratory Distress Syndrome, Newborn - blood; Respiratory Distress Syndrome, Newborn - drug therapy; Risk factors; Saliva; Saliva - metabolism; Sensitivity and Specificity; Statistics as Topic; Telemedicine; Theophylline; Theophylline - pharmacokinetics; Romania
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/sj.jp.7211804

To evaluate the reliability of salivary levels of theophylline in monitoring therapy of apnoea of prematurity. Aminophylline was administered intravenously in 13 infants with apnoea, in a loading dose of 5 mg/kg and maintenance dose of 3 mg/kg, every 8 h. The patients were divided into two groups according to their postconceptional age (PCA): group A, of infants with small PCA (32.8+/-2.0 weeks; n=6 cases), and group B, infants with higher PCA (37.1+/-0.8 weeks; n=7 cases). A total of 57 paired samples of serum and saliva were obtained in all 13 infants. The mean serum level of theophylline was 7.8+/-5.8 microg/ml and the ratio between serum and salivary concentration of theophylline was 1.53+/-0.28. A strong correlation between the serum and salivary concentration of theophylline (r=0.973) was found. Infants with small PCA had significant higher serum concentration of theophylline than those with higher PCA (10.6 vs 5.3 microg/ml; P=0.0002). The difference between the mean ratios of serum/salivary theophylline levels in the two groups was low (1.44 vs 1.62; P=0.0155). The strong correlation of theophylline in serum and in saliva recommends the salivary levels as a reliable method for monitoring the treatment of apnoea of prematurity.