Review of ciprofloxacin use in children.

BACKGROUND: The frequency of prescriptions for ciprofloxacin use in children is high despite the caution recommended. OBJECTIVE: To assess frequency of ciprofloxacin prescriptions in a pediatric unit and review the literature on use of ciprofloxacin in children. METHODS: Patient case notes in a pediatric general ward of a tertiary hospital were reviewed. Electronic databases were searched for articles published in English between January2001 and December2011. RESULTS: Ciprofloxacin was prescribed for 20% of the children in our preliminary study. In all the studies reviewed ciprofloxacin was used as a second line treatment in life-threatening cases and only for organisms that were susceptible on culture. Adverse events such as arthralgia, gastro intestinal disturbances and CNS reactions were recorded; they were reversible and often did not warrant discontinuation of therapy. CONCLUSION: Ciprofloxacin may be used in children as second line treatment, in life-threatening cases, for susceptible organisms when the benefit outweighs the risk.

Trends in hospital admissions for sickle cell disease in England, 2001/02-2009/10.

BACKGROUND: Sickle cell disease (SCD) is a rising cause of mortality and morbidity in England and consequently an important policy issue for the National Health Service. There has been no previous study that has examined SCD admission rates in England. METHODS: Data from Hospital Episode Statistics were analysed for all hospital episodes (2001/10) in England with a primary diagnosis of sickle cell anaemia with crisis (D57.0) or without crisis (D57.1). Secondary and tertiary diagnoses were examined among those patients admitted with either of these codes as their primary diagnosis. RESULTS: The overall SCD admission rate per 100 000 has risen from 21.2 in 2001/02 to 33.5 in 2009/10, a rise of over 50%. London accounts for 74.9% of all SCD admissions in England. 57.9% of patients admitted are discharged within 24 h. The largest rise in admission rates was seen among males aged 40-49 years where admission rates per 100 000 increased from 7.6 to 26.8 over the study period. CONCLUSIONS: Our data show that SCD admissions are rising in England, particularly in London. Over half of patients admitted with SCD were discharged within 24 h, suggesting that some of these admissions could be prevented through better ambulatory care of patients.