ABSTRACT
The clinical efficacy and safety of a three-day course of azithromycin was evaluated in 39 children (aged 1-15 years) with clinical diagnosis of acute upper respiratory tract infections (acute pharyngitis and/or acute tonsillitis, acute otitis media and acute sinusitis). Patients received azithromycin in a single daily dose of 10 mg/kg (maximum 500 mg) orally for three days. Clinical assessment and throat culture were carried out before and after therapy. Overall clinical efficacy was fund to be satisfactory (cured or improved) in 37/39 (94.8 percent) of patients. Bacteriological efficacy, which was evaluated by eradication of the pathogens, was found in 16/18 (88.8 percent). In the remaining two patients, one was clinically cured despite persistent Staphylococcus aureus, while the other case of clinical failure was associated with a resistant strain of Psuedomonas seruginosa. The drug was well tolerated and treatment-related side-effects, which were reported in only 3*39 (7.69 percent) of the patients, were gastrointestinal in nature and of mild severity. The results of the study indicated that a single daily dose, in a three-day regimen, of azithromycin is effective and well-tolerated in the treatment of children with acute upper respiratory tract infections.
ABSTRACT
A retrospective study was made on seventy-one infants and children born to HIV-1 infected mothers, who admitted and expired at Department of Pediatrics, Siriraj Hospital from September 1991 to August 1995. Sixty-three were diagnosed to be HIV infected and 8 were undetermined. In the group of undetermined HIV-infection, the causes of death included sepsis, prematurity, pneumonia and congenital heart disease. Among the 63 of HIV-infected group, 25 (40%) died before age 6 months, 36 (57%) and diarrhea 29 (46%). Other causes of death included gastrointestinal heamorrhage, congestive heart failure, candida esophagitis, wasting syndrome and liver failure. P.carinii was identified in 5 cases (12.2%) among the group of children who died with pneumonia. Of 36 children who died with sepsis, the etiologic agent were confirmed by blood culture 29 (80.5%). A single pathogen was isolated in 18 cases (62%) whereas multiple pathogens were isolated in 10 cases (38%) and only 1 yielded Candida albican. Gram-positive bacteria was identified in 11 cases (38%) which 8 cases (73%) of S.aureus were the most common isolated bacteria. Gram negative bacteria were confirmed in 22 cases (62%) of which 7 cases (32%) of salmonella species were the most frequent isolated bacteria. In the group of children who died of diarrhea, the causative agents wee identified in 12 cases (43%) by which 8 cases (66%) of cryptosporidium and 6 cases (50%) of salmonella species were the most common isolated pathogens. Among the 63 of HIV-infected children, 20 (32%) were the first admitted group and pneumonia 17 (85%) was found to be the most common cause of death.