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Cefuroxime therapy for pneumonia in infants and children
Insights
Cefuroxime effectively treats bacterial pneumonia in infants and children as a single antibiotic. This study found cefuroxime safe and effective, reducing fever and respiratory symptoms in young patients.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Pharmacology
Background:
- Bacterial pneumonia in infants is often caused by Streptococcus pneumoniae, Haemophilus influenzae b, and Staphylococcus aureus.
- Current treatment typically involves combination therapy with a beta-lactam antibiotic and chloramphenicol.
Purpose of the Study:
- To evaluate cefuroxime as a single-drug therapy for bacterial pneumonia in infants and children.
- To assess the safety and efficacy of cefuroxime in this patient population.
Main Methods:
- An open study involving 100 infants and children with suspected bacterial pneumonia.
- Cefuroxime administered at 75 mg/kg/day, divided every 8 hours (IV or IM).
- Serum and pleural fluid concentrations of cefuroxime were measured.
Main Results:
- Bacterial etiology confirmed in 20 patients, including H. influenzae b, S. pneumoniae, and S. aureus.
- All identified pathogens were susceptible to low doses of cefuroxime.
- Patients experienced a mean of 3.1 days to becoming afebrile and 5.1 days for respiratory symptoms to resolve.
Conclusions:
- Cefuroxime demonstrates safety and efficacy as a standalone treatment for pediatric bacterial pneumonia.
- Single-drug cefuroxime therapy offers a viable alternative to combination antibiotic regimens.
Abstract:
Because Streptococcus pneumoniae, Haemophilus influenzae b and Staphylococcus aureus are the major causes of bacterial pneumonia in infancy, we customarily have given a beta-lactam antibiotic and chloramphenicol as initial antibiotic therapy. Cefuroxime (75 mg/kg/day divided every 8 hours iv or im) was evaluated as single drug therapy in an open study of 100 infants and children with suspected bacterial pneumonia. The mean serum concentration of cefuroxime 30 minutes after a 15-minute infusion of 25 mg/kg iv was 29.1 micrograms/ml, and the volume of distribution was 695 ml/kg. Pleural fluid concentrations in 3 specimens were 2.2, 8.5 and 11 micrograms/ml. Median age of patients was 15 months. Bacterial etiology was established in 20 patients: H. influenzae b (8 patients); pneumococcus (8 patients); S. aureus (2 patients); Group A streptococcus (1 patient); Neisseria meningitidis B (1 patient). All organisms were susceptible to 1.25-micrograms/ml doses or less of cefuroxime. The mean number of days was 3.1 until patients became afebrile and 5.1 until respiratory symptoms were gone. Eosinophilia occurred in 10 patients. Cefuroxime is safe and effective single drug therapy for pneumonia in infants and children.