Abstract
An experience with ceftazidime in the treatment of newborns, young infants, and immunocompromised or neutropenic children is presented. A total of 24 seriously ill pediatric Patients with septicemia, cellulitis, pneumonia, peritonitis or meningitis were selected for the study. Patients were treated with dosages ranging between 90 and 150mg/kg per day for 7 to 50 days.
The patients were divided into three groups: Group 1 comprised nine normal hosts, including four newborns and five infants; Group 2 included ten compromised or neutropenic hosts after immunosuppressive treatments; seven of them were acute leukemia, one malignant teratoma, one Leiner's disease, and one nephrotic syndrome; Group 3 were five febrile neutropenic bone marrow transplant patients.
Bacteriologic etiologies were Pseudomonas aeruginosa in 12 episodes, P. aeruginosa plus Staphylococcus aureus in 1, E. coli in 2, Klebsiella pneumoniae in 2, Enterobacter aerogenes in 1, and one episode of polymicrobial infection with P. aeruginosa plus E. coli and Bacteroides fragilis. No microorganism isolation was found in five of the patients. The clinical efficacy in normal hosts with ceftazidime monotherapy was 89 percent, with only one failure due to polymicrobial infection. Among the 15 compromised or neutropenic hosts, 12 (80 percent) were cured or improved with bacterial eradication, 2 improved initially but died of superinfection subsequently and 1 died of pneumonia with empyema due to a resistant strain of P. aeruginosa.
The overall cure or improvement rate was 83.4 percent (two superinfections ercluded). It is important to emphasize that 11 (91.7%) of 12 cases with P. aeruginosa infection were cured (9 cases) or improved (2 cases) after ceftazidime treatment. No significant toxicities were noted.
These data suggest that ceftazidime is safe and effective in the treatment of aerobic gram-negative, especially P. aeruginosa, infections in newborns, young infants and immunocompromised or neutropenic children.
The patients were divided into three groups: Group 1 comprised nine normal hosts, including four newborns and five infants; Group 2 included ten compromised or neutropenic hosts after immunosuppressive treatments; seven of them were acute leukemia, one malignant teratoma, one Leiner's disease, and one nephrotic syndrome; Group 3 were five febrile neutropenic bone marrow transplant patients.
Bacteriologic etiologies were Pseudomonas aeruginosa in 12 episodes, P. aeruginosa plus Staphylococcus aureus in 1, E. coli in 2, Klebsiella pneumoniae in 2, Enterobacter aerogenes in 1, and one episode of polymicrobial infection with P. aeruginosa plus E. coli and Bacteroides fragilis. No microorganism isolation was found in five of the patients. The clinical efficacy in normal hosts with ceftazidime monotherapy was 89 percent, with only one failure due to polymicrobial infection. Among the 15 compromised or neutropenic hosts, 12 (80 percent) were cured or improved with bacterial eradication, 2 improved initially but died of superinfection subsequently and 1 died of pneumonia with empyema due to a resistant strain of P. aeruginosa.
The overall cure or improvement rate was 83.4 percent (two superinfections ercluded). It is important to emphasize that 11 (91.7%) of 12 cases with P. aeruginosa infection were cured (9 cases) or improved (2 cases) after ceftazidime treatment. No significant toxicities were noted.
These data suggest that ceftazidime is safe and effective in the treatment of aerobic gram-negative, especially P. aeruginosa, infections in newborns, young infants and immunocompromised or neutropenic children.
| Translated title of the contribution | 應用於小兒重症感染之臨床評估 |
|---|---|
| Original language | English |
| Pages (from-to) | 420-429 |
| Number of pages | 10 |
| Journal | Acta Paediatrica Sinica |
| Volume | 28 |
| Issue number | 6 |
| Publication status | Published - 1987 |
| Externally published | Yes |
Keywords
- Ceftazidime
- neonatal infections
- immunocompromised host
- febrile neutropenic patient
- Pseudomonas aeruginosa