Ostéomyélites aiguës de l’enfant drépanocytaire en zone tropicale : intérêt de l’utilisation des fluoroquinolones par voie orale

Abstract

Aim. – This study was designed to assess the efficacy and the safety of fluoroquinolones in their compassionate use for acute osteomyelitis in children with sickle cell disease in a tropical country. Patients and methods. – This study was non comparative, including twelve children (eight SS, three SC and one SE°thalassemia) treated for acute osteomyelitis with oral ciprofloxacin or ofloxacin because of the following reasons : financial inability to afford conventional parenteral beta-lactams therapy (nine patients), refusal of hospitalization (two patients), and failure of conventional treatment (one patient). Results. – The mean age of patients was 9,5 ± 2,6 years. The long bones were the predominantly site. Salmonella species were present in 75 % of cases, followed by other enterobacteriaceae (16,7 %), and Staphylococcus aureus (8,3 %). Successful outcome occurred in all cases after three to four weeks of treatment and 45 days of plaster immobilization. Transient bilateral Achilles tendon tendinitis was noted in a five-year-old patient. Conclusion. – In economically developing countries, oral fluoroquinolones may be a therapeutic alternative for acute osteomyelitis in patients with sickle cell disease particularly in cases of financial hardship or failure with conventional therapy.