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[Clinical evaluation of cefsulodin in Pseudomonas infections in children]
Insights
Cefsulodin (CFS) effectively treated most Pseudomonas aeruginosa infections in children. This antibiotic demonstrated safety and efficacy, though narrow spectrum necessitates consideration for polymicrobial cases.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
Context:
- Pseudomonas aeruginosa is a significant pathogen in pediatric infections.
- Limited treatment options exist for severe pediatric Pseudomonas aeruginosa infections.
Purpose:
- To evaluate the safety and efficacy of Cefsulodin (CFS) in pediatric patients with Pseudomonas aeruginosa infections.
Summary:
- Cefsulodin (CFS) was administered intravenously to 14 children with various P. aeruginosa infections.
- CFS showed clinical and bacteriological efficacy in most cases, with one resistant pneumonia case responding poorly.
- Mild transient eosinophilia was the only adverse effect; no severe reactions were noted.
Impact:
- Cefsulodin (CFS) is a safe and effective antibiotic for susceptible Pseudomonas infections in children.
- Its narrow spectrum suggests combination therapy may be beneficial for polymicrobial infections.
Abstract:
Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.