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Cefuroxime therapy for bacteremic soft-tissue infections in children
Insights
Cefuroxime is effective for treating pediatric soft-tissue infections in the US. This study showed a satisfactory clinical response in all patients treated with intravenous cefuroxime.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Limited US data exists on pediatric cefuroxime use.
- Cefuroxime is widely used in Europe for pediatric infections.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous cefuroxime in US children.
- To assess cefuroxime's effectiveness against specific soft-tissue infections.
Main Methods:
- 36 children (3.5-57 months) received IV cefuroxime (75 mg/kg/day).
- Treated infections included preseptal cellulitis, buccal cellulitis, and epiglottitis.
- Pathogens identified: Haemophilus influenzae type b, Streptococcus pneumoniae.
Main Results:
- All 36 patients showed a satisfactory clinical response.
- Blood cultures became sterile in initially bacteremic patients.
- Cefuroxime was well tolerated; granulocytopenia occurred in 6 patients but was not drug-attributed.
Conclusions:
- Intravenous cefuroxime is a safe and effective treatment for pediatric soft-tissue infections.
- Effective against infections caused by Haemophilus influenzae and Streptococcus pneumoniae.
- Further controlled studies are needed to confirm safety findings.
Abstract:
Although it is used extensively in Europe, there is a limited amount of published data concerning pediatric clinical experience with cefuroxime in the United States. Thirty-six children, ranging from 3.5 to 57 months of age, received intravenous cefuroxime (75 mg/kg/day in three divided doses) for soft-tissue infections of the face or epiglottis. Infections treated included preseptal (19 patients) and buccal (13 patients) cellulitis and epiglottitis (four patients). Blood cultures were positive in 22 patients, yielding Haemophilus influenzae type b in 17 (four were beta-lactamase-positive), Streptococcus pneumoniae in four; and beta-lactamase-positive, nontypable H influenzae in one. An additional five patients with buccal cellulitis had negative blood cultures but H influenzae type b antigenuria. A satisfactory clinical response was noted in all patients, and repeated blood cultures performed in initially bacteremic patients were sterile. Cefuroxime therapy was well tolerated, and abnormal laboratory results were infrequent, except for absolute granulocytopenia (granulocytes, less than 1,500/cu mm), which occurred in six patients but could not be ascribed to a drug effect because of the uncontrolled design of our study. Treatment with cefuroxime appears to be a safe and effective therapy for pediatric soft-tissue infections due to H influenzae and S pneumoniae.