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[Indications for piperacillin in pediatrics]
Insights
Piperacillin demonstrated significant clinical effectiveness in treating severe pediatric infections, achieving an 85% cure or improvement rate. This antibiotic was well-tolerated, showing promise for specific pediatric cases, especially when combined with aminoglycosides.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Pharmacology
- Bacteriology
Context:
- Severe infections in children pose significant clinical challenges.
- Accurate bacteriological diagnosis is crucial for effective treatment.
- Piperacillin is a broad-spectrum penicillin antibiotic.
Purpose:
- To evaluate the clinical efficacy and tolerability of piperacillin in pediatric patients with severe infections.
- To determine optimal dosing and combination therapy regimens.
Summary:
- A study assessed piperacillin in 34 children with severe infections (septicaemia, meningitis, etc.).
- Treatment involved a mean of 220 mg/kg/day for 11 days, often combined with aminoglycosides.
- 85% of patients showed clinical cure or improvement with good tolerability.
Impact:
- Piperacillin shows potential for treating severe Gram-negative infections in pediatric patients with cystic fibrosis or neutropenia.
- It is also recommended for intensive care unit-acquired infections or febrile leucopenia in children, particularly when combined with aminoglycosides pending bacteriological results.
Abstract:
The clinical activity of piperacillin was evaluated in 34 children (mean age: 8 years) presenting with severe infection (septicaemia, meningitis, bronchopneumonia, pyelonephritis). A bacteriological diagnosis was established in 24 cases. The mean duration of treatment was 11 days, and the mean dose 220 mg/kg/day administered in three injections. In 25 cases piperacillin was combined with another antibiotic, usually an aminoglycoside (20 cases). Clinical cure or improvement was obtained in 29 children (85%). Treatment was well tolerated, with only 2 cases of moderate blood eosinophilia. In view of these results the authors suggest that piperacillin could be used in children in two circumstances: severe infections caused by Gram-negative cocci or bacilli in children with cystic fibrosis or neutropenia, and against infections contracted in intensive care units, or in children with febrile leucopenia, combined with an aminoglycoside in the absence of, or pending bacteriological results.