RESUMO
To reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients, the use of taurolidine was introduced in the Sophia Children's Hospital in 2011. This introduction led to a reduction in catheter-related bloodstream infections: 12.7/1000 catheter days before the use of taurolidine, compared with 4.3/1000 catheter days afterwards (n = 7) [relative risk = 0.36, 95% confidence interval: 0.20-0.65 (P = 0.018)].
Assuntos
Anti-Infecciosos/uso terapêutico , Bacteriemia , Infecções Relacionadas a Cateter , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Taurina/análogos & derivados , Tiadiazinas/uso terapêutico , Anti-Infecciosos/administração & dosagem , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Bacteriemia/prevenção & controle , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Nutrição Parenteral no Domicílio/efeitos adversos , Nutrição Parenteral no Domicílio/métodos , Estudos Retrospectivos , Taurina/administração & dosagem , Taurina/uso terapêutico , Tiadiazinas/administração & dosagemRESUMO
A 5-month-old girl was diagnosed with tuberculosis, mimicking ileocecal intussusception. The mother of the patient was later diagnosed with renal tuberculosis attributable to the same (unique) Mycobacterium tuberculosis strain. Possibly, that transmission occurred by aspiration or ingestion of infected amniotic fluid or urine, which could occur before or during birth. This case illustrates that tuberculosis can mimic other common diseases and, therefore, can be a difficult diagnosis to make. Because respiratory infection was very unlikely in this case, congenital tuberculosis or postnatal infection via infected urine or breast milk should be in the differential diagnosis. In this article, we focus on different (nonrespiratory) transmission routes of Mycobacterium tuberculosis and give a short review of the recent literature on congenital tuberculosis.
Assuntos
Valva Ileocecal , Intussuscepção/diagnóstico , Tuberculose Miliar/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Doenças do Íleo/diagnóstico , Lactente , Tuberculose/congênito , Tuberculose/transmissão , Tuberculose Renal/diagnósticoRESUMO
BACKGROUND: Recently, a new tablet formulation of the widely used HIV protease inhibitor lopinavir/ritonavir was licensed. Here, we present a pilot study of the pharmacokinetics of the new adult tablet formulation taken once daily in children. METHODS: Lopinavir pharmacokinetics of the new adult tablet formulation were evaluated in 15 HIV type-1-infected children between 4 and 15 years of age. A target dose of 460/115 mg/m2 was administered once daily. Plasma concentrations of lopinavir over the course of 24 h were determined with a validated HPLC method. RESULTS: The median lopinavir dose was 498 mg/m2 (range 424-548). The mean +/- SD for lopinavir area under the 24 h curve was 217.9 +/- 44.9 mg/l x h, the maximum concentration was 14.8 +/- 2.4 mg/l and the concentration 24 h after intake was 3.1 +/- 2.6 mg/l. The half-life of lopinavir was 5.8 +/- 4.5 h and the median time to maximum concentration was 5.8 h (range 1.8-12.2). Overall, the tablet formulation resulted in greater exposure to lopinavir with less variability compared with the soft-gel capsule formulation. All children treated with the new adult tablet formulation had undetectable viral loads (< 50 copies/ml) during 24 weeks follow-up. CONCLUSIONS: The tablet formulation could probably result in improved lopinavir dosing and increases the feasibility of once-daily lopinavir/ritonavir-based regimens in children.
