In this open study, 93 children (aged 2-12 years) with a clinical diagnosis of pharyngitis or tonsillitis caused by Streptococcus pyogenes (culture and/or ELISA test positive) were given azithromycin, as a single daily dose of 10 mg/kg (maximum 500 mg) for three days (n = 46); or erythromycin ethylsuccinate, 30-50 mg/kg daily given in three divided doses, for ten days (n = 47). Forty-four of 46 azithromycin patients, and 46 of 47 erythromycin patients, had S. pyogenes isolated at baseline and were included in the clinical and bacteriological analyses. At the end of treatment (day 10-12), 38 (86%) of the 44 azithromycin patients were considered cured, four (9%) improved, one (2%) failed and one relapsed. In the erythromycin group, 30 of 46 (65%) were considered cured, 15 (33%) improved and one (2%) failed. Eradication of S. pyogenes was achieved in 40 of 44 (91%) and 45 of 46 (98%) azithromycin and erythromycin patients, respectively. Re-occurrence of S. pyogenes, assessed 28-32 days after start of treatment, occurred in five of 37 (14%) azithromycin patients (three with clinical symptoms) and five of 39 (13%) erythromycin patients (four with clinical signs). There were no statistically significant differences in clinical or bacteriological efficacy between the two groups. Both drugs were well-tolerated, with side-effects (mainly gastrointestinal) reported in five of 46 (11%) azithromycin patients and in six of 47 (13%) erythromycin patients, one of whom withdrew from treatment. No laboratory abnormalities were observed in the azithromycin patients, but were recorded in two of 43 (5%) erythromycin patients.(ABSTRACT TRUNCATED AT 250 WORDS)
A total of 33 patients with bacterial meningitis were treated with single daily doses of ceftriaxone (CTR 100 mg/kg/day i.v.) for a median duration of 13 days. Pathogens isolated by culture and/or determined by latex agglutination were 15 Haemophilus influenzaeh, 7 Neisseria meningitidis, 2 Streptococcus pneumoniae, 1 group B streptococcus, 2 Streptococcus viridans and 2 Staphylococcus epidermidis. In 4 cases a diagnosis of purulent meningitis could only be made by means of the inflammatory liquor parameters. All cerebrospinal fluid (CSF) drug levels even at the end of the dosing interval were at least 10-fold higher than the MICs of the respective bacterial isolates. The average penetration of CTR into the CSF was 6.6%. Within 12–46 h after the first dose, control spinal taps were performed. Cultures were sterile in all cases. Side effects encountered were diarrhea, exanthema, neutropenia and transient elevation of glutamic oxaloacetic transaminase, but none caused a change of therapy. One patient developed a biliary concrement. No patient died; 5 patients had prolonged fever ( > 5 days), and 2 were left with persistent hearing deficiencies. CTR can be recommended as a safe and effective antibiotic agent for once daily treatment of bacterial meningitis in children.
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