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Biomedical subjects

B Quinet

Publications and source records attributed to B Quinet.

48 records · Page 3Linked to original sources

[Role of ceftazidime in severe infections in children. Review of the literature].

Ceftazidime has the same antibacterial spectrum as the other third generation cephalosporins, but it is the most active of all against Pseudomonas aeruginosa. A review of the literature concerning severe infections shows that ceftazidime has been used in children mainly to treat superinfections on cystic fibrosis, infections in immunocompromised subjects and neonatal infections. The results in large series of patients were highly satisfactory and the drug was well tolerated. Other diseases treated in shorter series were: urinary tract infections in paediatric urology, ENT infections caused by P. aeruginosa, cellulitis and post-operative infections. A multicentre trial involving 344 children has recently been reported, showing very good results (clinical cure in 95 per cent of the cases). Ceftazidime dosage varies from one study to another, but a mean daily dose of 150 mg/kg is often necessary in septicaemias and infections associated with cystic fibrosis.

Bacterial Infections↗

Efficacy and pharmacokinetics of Timentin in paediatric infections.

Twenty-four children, ten of whom had an infection due to ticarcillin-resistant, Timentin-sensitive bacteria, were treated with Timentin. A full clinical success was obtained in sixteen cases (13 pyelonephritis, nine of them due to ticarcillin-resistant, Timentin-sensitive Escherichia coli, two neonatal infections and one pneumonia). Four children were improved (1 bronchiectasis, 3 leukaemias), three were unassessable and one failure occurred with a staphylococcal urinary tract infection. A pharmacokinetic study was performed in three newborns (under three months) and ten children (mean age 3 years). Timentin was administered as four daily 30-min iv infusions. The mean dosage used in patients under three months was 225 mg/kg/d ticarcillin and 9 mg/kg/d clavulanic acid. In infants older than three months of age the mean dosage was 250 mg/kg/d ticarcillin and 16 mg/kg/d clavulanic acid. The pharmacokinetic results demonstrated similar serum concentrations of ticarcillin to those in earlier studies, and serum concentrations of clavulanic acid of 3.1 +/- 0.63 mg/l and 2.18 +/- 0.17 mg/l at 1 h and 2 h respectively after infusion in newborns. For children, at the same times, the serum levels were respectively 2.3 +/- 0.9 mg/l and 1.4 +/- 0.9 mg/l. The peak serum concentrations of clavulanic acid were the same in the two groups of dosages (4.7 mg/l), but the half-lives of clavulanic acid were 1.1 h in children older than three months and 1.8 h in infants younger than 3 months. The tolerance was good. Timentin may be useful as a first line antibiotic in infections in hospitalized children in the dosage described, as three or four injections daily, according to the age and the severity of the disease.

Adolescent↗

[Multicenter clinical study and pharmacokinetics of ceftazidime in children and newborn infants].

The pharmacokinetics and clinical efficacy of ceftazidime, a new cephalosporin with activity against Pseudomonas aeruginosa, were studied in children and neonates. Our studies suggest that ceftazidime should be considered for the treatment of sever infections in pediatric patients (neonatal septicemia and meningitis, urinary tract infections due to multiresistant bacteria) and for the empirical therapy of febrile episodes in immunocompromised children. Ceftazidime appears to be effective and safe, alone or associated with an aminoglycoside, in the treatment of acute exacerbation in cystic fibrosis. The dosage recommended on the basis of our pharmacokinetic studies is 30 to 50 mg/kg intravenously every eight hours for infants and children and 30 mg/kg every 12 hours for neonates. Larger doses should be used in cystic fibrosis patients, immunosuppressed children, meningitis, and bacterial infections due to organisms with high MICs.

Adolescent↗

[Pathology of the bile ducts in children with homozygous sickle-cell anemia. Apropos of 5 recent cases].

Five cases of biliary complications in childhood sickle cell disease are reported. In four cases, the pathology was gall stones causing recurrent abdominal pain in a 10 year old boy, a 13 year old girl and a 2 year old infant, and responsible for a "Salmonella septicaemia" in a 17 year old adolescent. In one case, a biliary cyst was diagnosed at 3 years of age. Four children underwent successful surgery. The complications of gall stones are difficult to distinguish from episodes of vasoocclusive abdominal pain. Ultrasonography is an easy method of detecting gall stones and may be repeated regularly in children over 10 years of age. All the children operated in this series were improved by surgery. Patients with sickle cell disease must be carefully prepared for general anaesthesia with a strict protocol of blood transfusion which is only possible in well equipped centers. Elective surgery is by far the best management as postoperative complications are much less common than after emergency surgery. A review of the literature shows that the general tendency is for surgical intervention as gall stones are a cause of recurrent abdominal pain, cholecystitis and dangerous infective complications in those patients.

Adolescent↗

[Extensive cerebral infarction in a case of hemolytic-uremic syndrome].

A hemolytic-uremic syndrome is reported in a 9 month-old girl. It was remarkable because of the severity of the renal lesions, which ended in terminal renal failure; there were also neurologic changes, responsible for a coma of 3 month-duration and for right-sided hemiplegia. Two CT scan examinations showed a left hemispherical hypodensity, resulting from a largely extended infarction in the sylvian area. After a 3 year's follow-up, the magnitude of the clinical improvement shows the possibility of neurologic recovery in children.

Cerebral Infarction↗

[Pharmacokinetic study of cefotaxime in newborn infants and infants].

The serum kinetics of intravenous cefotaxime was studied in 13 neonates and 5 infants presenting with bacterial infections in order to establish the dosage and route of administration. Average dosage was 66.6 mg/kg/day in neonates and 62 mg/kg/day in infants. Cefotaxime was given intravenously in 3 daily bolus injections in infants and 2 bolus injections in neonates under 8 days of age. In infants the average serum peak was 173 mcg/ml at 15 min. Serum half-life was between 0.45 and 0.50 hr (T 1/2 beta) close to the one found in adults. In neonates the average serum peak was 106.2 mcg/ml at 35 min. Serum half-life was 1.71 hr (T 1/2 beta). It is prolonged in neonates who are younger, more premature and have a lower weight. In full term neonates, during the first 8 days, the desirable dose seems to be 75 to 150 mg/kg/day in 3 injections, according to the severity of the infection. In premature neonates under 8 days of age, the interval between injections should be increased up to 12 hrs. Finally, in full term neonates older than 8 days and in infants, one injection every 6 hours seems to be advisable.

Bacterial Infections↗