Multicenter randomized study of two once daily regimens in the initial management of community-acquired respiratory tract infections in 163 children: azithromycin versus ceftibuten.

In a randomized trial, we compared the efficacy and toxicity of azithromycin and ceftibuten once daily in the initial (empiric) therapy of proven or suspected community-acquired respiratory tract infections (CARTI) in 163 pediatric patients: 95.5% of those treated with azithromycin and 83.6% of those treated with ceftibuten were cured or improved. Streptococcus pneumoniae was more frequently eradicated in the azithromycin than in the ceftibuten group, whereas gram-negative bacilli were more susceptible to ceftibuten. Elimination rates for Staphylococcus aureus and Haemophilus influenzae were similar; adverse reactions did not differ in both arms. Thus, azithromycin was more effective but equally safe than ceftibuten in the initial therapy of pediatric CARTI.

Magnetic resonance imaging in children receiving quinolones: no evidence of quinolone-induced arthropathy. A multicenter survey.

Twenty-nine children with cystic fibrosis (CF) were investigated for quinolone-induced arthropathy. Magnetic resonance imaging (MRI) was performed in 14/14 children treated with ofloxacin or ciprofloxacin and in 10/15 of those never treated with quinolones. The frequency of pathologic MRI findings, concerning cartilage thickness, careful analysis of the cartilage structure, presence of edema, cartilage-bone borderline and the presence of fluid in joints did not show any difference between both groups. Thus the presence of quinolone-induced arthrotoxicity cannot be confirmed in this study.

Aureobasidium mansoni meningitis in a leukemia patient successfully treated with amphotericin B.

Aureobasidium mansoni fungal meningitis in a 30-year-old leukemic patient is reported. This is the first reported case of Aureobasidium spp. central nervous system infection. The patient was successfully treated with systemic antifungal chemotherapy with a total dose of 2.2 g of amphotericin B.

Fluconazol plus ofloxacin in prophylaxis of infections in patients with acute leukemia: a comparative study.

In a retrospective study the incidence of infections, number of afebrile days, duration of antimicrobial chemotherapy, and cost of antibacterials and antimycotics were compared in two groups of patients. One was a group of 57 patients who received no prophylaxis during induction remission therapy of acute leukemia treated in 1989-1990, the second was a group of 22 patients treated in 1991 where prophylaxis with fluconazol and ofloxacin was administered. For ethical reasons pertaining since 1991, when prophylaxis became mandatory, the study was not randomized. A decrease in the number of febrile days, the cost of antimicrobials and the duration of treatment with antibiotics and antimycotics was observed in the group receiving fluconazol and ofloxacin.

Fungal pathogens in etiology of septic shock in neutropenic patients with cancer (short communication).

During the 3 years from 1989 to 1991, we evaluated the etiology of septic shock cases and infection-associated mortality. A total number of 38 patients was included in the study, according to the criteria for septic shock (SS), (Intensive Care Medicine Society, 1989). In 1989, P. aeruginosa and Enterobacteriaceae among the pathogens prevailed. In 1990 and 1991, S. aureus, enterococci and fungi were most frequent. From 8 patients with SS in 1990, the shock was due to Candida albicans in 1 and to mucoraceae in 3 patients. In 10 patients examined in 1991, 8 cases of SS were due to Candida albicans, Aspergillus niger, Fusarium solani and Acremonium strictum. The decrease of the incidence of shocks and increase of fungal etiology were found to be associated with the use of quinolones in prophylaxis and cephalosporines, aminoglycosides and vancomycine in empiric therapy in febrile neutropenic patients.

Ceftriaxone versus ceftazidime plus aminoglycoside therapy for infections in patients with neutropenia after cytotoxic chemotherapy. Short communication.

One hundred and one patients undergoing anticancer chemotherapy due to hematologic malignancy were retrospectively divided into two groups: 67 patients were treated with ceftriaxone plus amikacin, receiving once daily (od) 2-4 g ceftriaxone, 1-1.5 g amikacin (those without a peripheral or central venous catheter) and 34 patients with central or peripheral venous catheter (CPVC) receiving ceftizidime 2 g three times daily (tid) plus amikacin 0.5 g tid i.v. Both groups were similar as to their isolated pathogens, localization of infection, and basic diagnoses of hematologic malignancies. There was no significant difference in efficacy between ceftriaxone plus amikacin versus ceftazidime plus amikacin, but the toxicity was lower in once daily ceftriaxone plus amikacin group.