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[Enterobacter-osteomyelitis in two neonates (author's transl)]
Insights
Two newborns with enterobacter-sepsis and osteomyelitis showed limited response to initial antibiotics. Subsequent Chloramphenicol treatment was effective but carried risks, including reversible bone marrow suppression in one infant.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Pharmacology
Background:
- Enterobacter sepsis is a serious infection in neonates.
- Osteomyelitis can be a complication of neonatal sepsis.
- Initial antibiotic resistance is a growing concern in treating neonatal infections.
Observation:
- Two neonates presented with enterobacter-sepsis and subsequent osteomyelitis.
- Standard antibiotic treatments (Gentamycin, Chepazolin) were ineffective.
- Chloramphenicol was used as a salvage therapy, with tetracycline in one case.
Findings:
- Chloramphenicol treatment led to clinical improvement in both cases of enterobacter-sepsis and osteomyelitis.
- One patient experienced dose-dependent, reversible bone marrow suppression attributed to Chloramphenicol.
- This suggests Chloramphenicol can be effective but requires careful monitoring in neonates.
Implications:
- Chloramphenicol may be a viable option for multidrug-resistant neonatal sepsis and osteomyelitis.
- Neonatal bone marrow response to Chloramphenicol necessitates vigilant monitoring.
- Further research into optimal dosing and safety profiles of Chloramphenicol in neonates is warranted.
Abstract:
Two boys aged up to 2 weeks suffered from enterobacter-sepsis. In both cases osteomyelitis developed in spite of treatment with Gentamycin or Gentamycin combined with Chepazolin. Both children were, taking accont of the risks, then treated with Chloramphenicol (100 mg/kg body weight/24 hours) and the first patient also, for a short time, with tetracyclin. In the second patient we saw a marrow depression dependent on Chloramphenicol and its dosage which disappeared rapidly, when the drug was withheld.