Ceftriaxone treatment of penicillinase-producing Neisseria gonorrhoeae infections in children.
The incidence of penicillinase-producing Neisseria gonorrhoeae (PPNG) among adults with gonorrhea in Brooklyn now exceeds 24%. Because children usually acquire their infection from adults, it follows that we have had a concomitant rise in PPNG among sexually abused children. The Centers for Disease Control now recommends ceftriaxone for the first line treatment of gonorrhea but there are no data as to its use in children for this indication. From May, 1987, through March, 1989, 33 children, 4 days to 10 years of age, were admitted to Kings County Hospital for 34 episodes of gonorrhea. Nine (26.5%) were caused by PPNG. Twenty-three were female; 10 were male. There were 17 isolates from the vagina, 3 from the urethra, 9 from the pharynx, 9 from the rectum and 6 from the eye. Eight children (all girls) had infections at greater than or equal to 1 site; 2 were infected at 3 sites. Twenty-eight children were sexually abused and 5 were neonates with ophthalmia (1 PPNG). All isolates were susceptible to ceftriaxone by disc diffusion testing. Agar dilution was performed for 18 isolates; minimal inhibitory concentrations to ceftriaxone were less than or equal to 0.06 mg/liter. The 5 PPNG isolates tested had minimal inhibitory concentrations to penicillin of 2 to 16 mg/liter and 3 isolates were resistant to tetracycline with minimal inhibitory concentrations of 32 mg/liter. Twenty-eight children were treated with a single dose of ceftriaxone, including the 5 neonates with ophthalmia; the dose was 125 mg if less than 45 kg or 250 mg if greater than 45 kg.(ABSTRACT TRUNCATED AT 250 WORDS)
Rawstron
S A
SA
Department of Pediatrics, SUNY Health Science Center, Brooklyn, NY 11203.
Hammerschlag
M R
MR
Gullans
C
C
Cummings
M
M
Sierra
M
M
D002443:Ceftriaxone / Q000627:therapeutic use*; D002648:Child; D002650:Child Abuse, Sexual; D002675:Child, Preschool; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009519:New York City; D010403:Penicillin Resistance; D010405:Penicillinase / Q000096:biosynthesis
D002443:Ceftriaxone; D010405:Penicillinase