Resumen
La: nteraccion entre carbamazepina y cla' : tromicina na sido recien*emente repo'*ada en la literarura. Reportamos el caso de un nino de 8 anos, portador de epilepsia, qu'en presento una intoxicacion por carbamazepina luego de que se agregara clari'rom ; c'na al trotamiento. Despues de la segunda dosis del antib'otico el paciente se mostro sornno lento y con ataxia cerebelosa, derrostrandose una imoortan'e elevaci6n del nivel plasmat;co de carbamczepira. El paciente reccbro su condicion normal rapidame r Me, luego de que se suspenclerc el antioioHco con la concoTiitante disminucion del nivel piasmatico de 1 cnticonvulsivante. Se ciscuten las caracteristicas de esta inreraccion de fcrmacos haciendo resaltar las caracteristicas del metabclismo de los nihos cue hace especialmente importa.nte esta situacion cl'nica (Polabras clave: carbamazepina, clarit r omicina, macro idos, interaccion de drogas, intoxicacion por drogas.]
Intoxication by carbamazepin with a two-clarithromycin doses, clinical reportClarithromycin and carbamazepine interaction has been recently reported in the litercture. Here we report an unusual early clinical intoxication when c^arithrcmyci 1 " was added to ccrbamazepine in a 8 yea' old boy who suffered from epilepsy. T^.ere was a h'gh elevation of corbaTiazepine plasma level associated with somnolence and cerebellar ataxla after the second dose of clarihromycin. The child recovered his "o-mal condition rap'c'ly after the withdrawal cf the antibiotic, with no'Tialization of the plasma level of carbanazepine. We discuss the charactheristics of he inte r action of these two drugs anc we stress tne special features of the children metabolism that may account for this interaction.(Key words: carbamazepine, clar'tiromycin, macrolides, drug toxicity, crug interaction.;La interaccidn entre carbamazepina y macroLa claritromicina es considerada el antibidtilidos, especialmente la eritromicina, ha sido re-co de primera linea en las infecciones por Myportada en la literatura. Tanto la carbamazepina coplasma neumonfa y es una de las primeras como estos amibidticos son metabolizados a ni-alternativas terapeuticas en las infecciones del vel hep^tico por la misma isoenzima del cito-tracto respiratorio alto, incluyendo otitis, sinucromo P450. Cuando ambos medicamentos son sitis e incluso neumonfas extrahospitalarias. administrados concomitantemente existe una in-Han sido reportados aproximadamente 10 cases teraccidn inhibitoria que resulta en una eleva-en que el uso concomitante de claritromicina y ci6n del nivel plasmdtico de carbamazepina. La carbamazepina resulto en una elevaci6n del niaparici6n de nuevos macrolidos como la clari-vel piasmatico de carbamazepina con signos clitromicina ha motivado la evaluaci6n formal de nicos de intoxicacion 2 ' 4 . La mayorfa de estos esta interaccion 1 " 3 . cases eran adultos y la intoxicacion clfnica aparecio tardfamente. ~ T~ , _ T " ] " . , ",, . ! Presentamos un nino con una clara intoxica-
Acute pyogenic arthritis during the newborn periodTo determine the ethiology of infections of the bones and joints during the newborn period a total of 29 patient charts hospitalized at the premature unit of the Luis Calvo Mackenna Hospital from November 1974 and June 1979 were analized.In 24,1% of all cases more than one joint was infected the hip was the joint most frequently involved (16 of 46 joints).The etiology was demostrated in 28 of 29 cases. Sinovial fluid pus and or blood cultures showed growth of S aureus or Klebsiella in 60,7 and 21,4% respectively, other bacteria isolated were P. aeruginosa in 7,1% Proteus, E. eoli and group B hemolytic Streptococcus being isolated each in 3,6% of cases.
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