Treatment of aspiration or tracheostomy-associated pneumonia in neurologically impaired children: effect of antimicrobials effective against anaerobic bacteria.

• Abstract: The purpose of the present study was to retrospectively review the antibiotic therapy of aspiration or tracheostomy-associated pneumonia in 57 neurologically impaired children (NIC). The antimicrobials used were either ticarcillin-clavulanate or clindamycin, which are effective against penicillin-resistant anaerobic bacteria, or ceftriaxone, which is less effective against these organisms. In those with aspiration pneumonia, a satisfactory clinical and microbiological response was observed in 8/9 (89%) patients who received ticarcillin-clavulanate, and 10/11 (91%) who received clindamycin with or without ceftazidime, as compared to 7/14 (50%) who received ceftriaxone (P < 0.05). For those who experienced tracheostomy-associated pneumonia, a positive response to therapy was observed in 5/6 (83%) who received ticarcillin-clavulanate, and 7/7 (100%) who received clindamycin with or without ceftazidime, as opposed to 4/10 (40%) who were treated with ceftriaxone (P < 0.05). The duration of fever was longer in both cases for those who received ceftriaxone. To summarize, this study illustrates the superiority of antimicrobials effective against penicillin-resistant anaerobic bacteria, as compared to an antibiotic without such coverage, in the therapy of aspiration or tracheostomy-associated pneumonia in NIC.
• Authors: I Brook (Affiliation: Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.)
• Journal: International journal of pediatric otorhinolaryngology (Int J Pediatr Otorhinolaryngol) Vol. 35 Issue 2 Pg. 171-7 (Apr 1996) ISSN: 0165-5876 [Print] IRELAND
• PMID: 8735413 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Cephalosporins
• Clavulanic Acids
• Penicillins
• Clindamycin
• Ticarcillin
• Clavulanic Acid
• Ceftriaxone
• Ceftazidime

Topics

• Adolescent
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Bacteria, Anaerobic (drug effects)
• Bacterial Infections (drug therapy)
• Ceftazidime (administration & dosage, therapeutic use)
• Ceftriaxone (administration & dosage, therapeutic use)
• Cephalosporins (administration & dosage, therapeutic use)
• Child
• Child, Preschool
• Clavulanic Acid
• Clavulanic Acids (administration & dosage, therapeutic use)
• Clindamycin (administration & dosage, therapeutic use)
• Female
• Fever (drug therapy)
• Humans
• Male
• Penicillins (administration & dosage, therapeutic use)
• Pneumonia, Aspiration (drug therapy, microbiology)
• Pneumonia, Bacterial (drug therapy, etiology)
• Retrospective Studies
• Seizures (complications)
• Ticarcillin (administration & dosage, therapeutic use)
• Tracheostomy (adverse effects)
• Unconsciousness (complications)