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Cefuroxime efficacy in pneumonia: sequential short-course i.v./oral suspension therapy
I Shalit1, R Dagan, D Engelhard
1Department of Pediatrics, Tel Aviv Sourasky Medical Center (Ichilov Hospital), Israel.
Insights
This study shows that switching pediatric patients with community-acquired pneumonia from intravenous to oral cefuroxime axetil is safe and effective. This approach ensures continuous antibiotic treatment for children, improving outcomes.
Area of Science:
- Pediatric infectious diseases
- Pharmacology
- Respiratory medicine
Background:
- Acute respiratory infections in children often require hospitalization and intravenous antibiotics.
- Early transition to oral antibiotic therapy is desirable for patient management and resource optimization.
- Cefuroxime axetil pediatric suspension enables a seamless switch from parenteral to oral administration.
Purpose of the Study:
- To evaluate the efficacy and safety of cefuroxime in treating community-acquired pneumonia in pediatric patients.
- To assess the transition from intravenous to oral cefuroxime therapy in children aged 3 months to 5 years.
Main Methods:
- An open-label study involving 84 pediatric patients (3 months to 5 years) diagnosed with lobar pneumonia.
- Intravenous (IV) cefuroxime (75 mg/kg/day) for 48-72 hours, followed by oral cefuroxime suspension (30 mg/kg/day).
- Inclusion criteria included chest X-ray evidence of lobar pneumonia, elevated white blood cell count, and fever.
Main Results:
- A high clinical success rate was observed, with 97.6% (82/84) of patients cured or improved post-treatment.
- Long-term follow-up confirmed sustained recovery, with 98.6% (73/74) of children remaining well.
- The treatment regimen demonstrated a favorable safety profile.
Conclusions:
- Sequential IV to oral cefuroxime axetil therapy is an effective and safe treatment for pediatric lobar pneumonia.
- This approach facilitates early transition to oral medication, ensuring continuous antibiotic coverage.
- The findings support the use of cefuroxime axetil suspension for managing community-acquired pneumonia in young children.
Abstract:
For children with acute respiratory infections in hospital, it is desirable to transfer from parenteral to oral therapy at the earliest opportunity. The introduction of a pediatric suspension of cefuroxime axetil provides a continuous course of one antibiotic with transition from injectable to oral therapy. This open study was designed to investigate the efficacy of cefuroxime in pediatric patients aged 3 months to 5 years with community-acquired pneumonia. Children had evidence of lobar pneumonia on chest X-ray, a white blood cell count of > 15,000/mm3 and a rectal temperature of > or = 38.5 degrees C on enrollment. Cefuroxime was given by i.v. injection at 75 mg/kg per day in three divided doses for 48-72 h followed by oral cefuroxime suspension at 30 mg/kg per day in two divided doses. Of 84 evaluable patients 82 (97.6%) were cured or improved post-treatment, and of 74 evaluable children who returned for follow-up assessment 73 (98.6%) remained well. Oral therapy with twice daily cefuroxime axetil suspension following 2-3 days of i.v. cefuroxime administration was confirmed as effective and safe treatment for lobar pneumonia in children under 5 years of age.