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Pefloxacin in steroid dependent and resistant idiopathic nephrotic syndrome

R K Sharma1, K M Sahu, S Gulati

  • 1Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. rksharma@sgpgi.ac.in

Journal of Nephrology
|August 18, 2000
PubMed

Insights

Peffloxacin offers a potential treatment for children with difficult-to-manage nephrotic syndrome, showing remission in 70% of patients. This fluoroquinolone antibiotic may help induce remission in steroid-dependent or resistant cases unresponsive to cyclophosphamide.

Area of Science:

  • Pediatric Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Nephrotic syndrome in children, particularly steroid-dependent or resistant forms, presents significant management challenges.
  • Previous treatments like cyclophosphamide may not always be effective, necessitating alternative therapeutic strategies.

Purpose of the Study:

  • To evaluate the efficacy and safety of pefloxacin in children with idiopathic nephrotic syndrome who are steroid-dependent or resistant and have previously failed cyclophosphamide therapy.

Main Methods:

  • A study group of ten children (8-14 years) with idiopathic nephrotic syndrome received pefloxacin (200-400mg twice daily) for 4-8 weeks without steroids.
  • Patients had previously completed a course of cyclophosphamide at least six months prior.
  • Outcomes were assessed after a mean follow-up of 18 weeks.

Main Results:

  • Seven out of ten patients achieved remission (2 complete, 5 partial) after pefloxacin treatment.
  • A significant reduction in proteinuria was observed (pre: 3.6+/-2.02gm/24h; post: 1.9+/-1.8gm/24h, p<0.006).
  • Side effects were minimal and reversible, including nausea, vomiting, arthralgia, and nail discoloration in a few patients.

Conclusions:

  • Peffloxacin may be a beneficial option for inducing remission in pediatric patients with steroid-dependent or resistant idiopathic nephrotic syndrome who are refractory to cyclophosphamide.
  • The drug demonstrated a favorable safety profile with manageable side effects in this specific patient subgroup.

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