Interaction of Influenza With Human Nasopharyngeal Mucosa

Abstract

Ke l'.1a n), St. Lou is University, St. Louis University Sch oo l of Medic ine , (;lennon Memorial Hospita l for Children, Department of Pediatrics/Adolescent Medicine, St. Louis , t10. S ingl e drug therapy with a broad spe ctrum antibiotic is a des irable o ption f or patient s with bone and joint infections of unkn own etiology. \ie initiated tre atment for 23 ch i ldren , ages 6 months-15 years (mean 6.5 years) with cefoxitin. The infecting organisms proved t o be Strep. pneumoniae-2, b-2, epidermidis, melaninogenicus, Mo raxella sp. and Ps. fluorescens-1 each. No agent was identified in 6 cases. lnitTaT clinical re sponse was good in21 cases (91 %). One primary re sis tant organism (Ps. fluorescens) and one cephalosporin-tol erant S. aureu s faile d to respond. A third child with infe ct ion due to H. Trif!Uenzae b developed meningitis after 3 days. These3, and 6 patients with neg at ive cultures, were drop ped from the study. All other patients did well and received x 15.7 days IV cefoxitin before swit ching to oral antimicrobials. Adverse reactions included allergic rash (1), mild eosinophilia (2) andmildelevation of SGOT (1). Cefoxitin was discontinued for reason of the ra s h ; all other reactions resolved when the drug was discontinued at the completion of therapy. Neutropenia (PMN <1000/mm3) was seen in 2 patients but resolved spontaneou s l y. Urinary reducing subs tance s wer e detected inS cases (22%). Cefoxitin ap pearstobe satisfactor y initial therapy for osteomyelitis an d sep tic arthriti s in pediatric patients; it should not be use d for infant s <2 years of age where H. influenzae b is suspected, due to the possible development of meningitis.