[Failure of the treatment with antibiotics in severe Salmonella infections in children and use of quinolones]

Arch Pediatr. 1995 Apr;2(4):317-23. doi: 10.1016/0929-693x(96)81152-3.
[Article in French]

Abstract

Background: Quinolone antibiotics are effective in the treatment of Salmonella infections in adults. Their use in children is limited by their side-effects.

Population and methods: Forty-two patients (21 girls and 21 boys), aged 1 month to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for severe Salmonella infections. Criteria of severity were persistent diarrhea and fever for more than 3 days. Thirty-one of these patients were less than 5 years of age. Blood culture was positive in 7 out of 35 patients: culture of the stools was positive in all patients. Five of the 42 patients had presented an acute episode of Salmonella infection a few weeks earlier and had remained asymptomatic carriers until the new acute and severe episode of diarrhea. All patients were given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime-sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12 mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and fever.

Results: Diarrhea and fever disappeared within less than 2 days in the group of patients given pefloxacin, even though in 6 patients the infecting Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients remained asymptomatic carriers of Salmonella in the group treated by pefloxacin vs 47% in the group without it. There was no difference in species of Salmonella between both groups. None of the patients treated by pefloxacin developed side-effects during the six months following its administration.

Conclusions: Short treatment by pefloxacin may be an alternative choice for treating severe Salmonella infections in children.

Publication types

  • English Abstract

MeSH terms

  • Amoxicillin / therapeutic use
  • Ampicillin / therapeutic use
  • Cefotaxime / therapeutic use
  • Ceftriaxone / therapeutic use
  • Child
  • Child, Preschool
  • Clavulanic Acids / therapeutic use
  • Female
  • Humans
  • Infant
  • Male
  • Pefloxacin / therapeutic use*
  • Salmonella Infections / drug therapy*
  • Treatment Failure
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Clavulanic Acids
  • Pefloxacin
  • Ceftriaxone
  • Ampicillin
  • Amoxicillin
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Cefotaxime