Systemic Infection In Children Research Articles

BIOAVAILABILITY AND CSF PENETRATION OF CIPROFLOXACIN IN EXPERMENTAL HAEMOPHILUS INFLUENZAE MENINGITIS

Ciprofloxacin (C) is a new quinolone antimicrobial with a broad spectrum of activity and oral bioavailability that may be useful for the therapy of systemic infections in children. Pharmacokinetics, CSF penetration and efficacy of this agent were studied in an infant rabbit model of bacteremic Haemophilus (Hib) meningitis induced by intranasal inoculation. C concentrations were determined by bioassay. Uninfected rabbits were given 25 or 50 mg/kg orally and intravenously.Serum concentrations (conc.) peaked 1-3 h after oral dosing and bioavailability (AUC po/AUC iv) was 40.5%. Rabbits with Hib meningitis were given C 50 mg/kg po q12h. Peak serum cone. (3.3±1.5) and (3.0 h) were similar to uninfected animals, but CSF cone, were higher (mean 0.14 ug/ml, penetration 7.8±1.6%). Serum cone. 12 h after an oral dose (0.16 ug/ml) were still 10X the Hib MIC. CSF cultures showed 2500 cfu/ml before and 16 cfu/ml 2h after treatment. CSF cultures at 6 h were sterile. C warrants further study in the treatment of systemic Hib infections.

Serotype and ampicillin susceptibility of Haemophilus influenzae causing systemic infections in children: 3 years of experience.

Over a 3-year period, 96% of systemic infections in children caused by Haemophilus influenzae were of serotype b. Of 346 invasive infections, 15 (4%) were caused by non-type b H. influenzae. The monthly prevalence of ampicillin resistance in all isolates was highly variable (0 to 63%). Ampicillin resistance in H. influenzae causing invasive disease occurred in 13% of non-type b and 21.8% of type b isolates. There was no significant difference (x2 - 0.21; p greater than 0.10) in the rate of ampicillin resistance between type b and non-type b H. influenzae causing systemic illness in children over a 3-year period.