[Failure of the treatment with antibiotics in severe Salmonella infections in children and use of quinolones].
BACKGROUND
Quinolone antibiotics are effective in the treatment of Salmonella infections in adults. Their use in children is limited by their side-effects.


METHODS
Forty-two patients (21 girls and 21 boys), aged 1 month to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for severe Salmonella infections. Criteria of severity were persistent diarrhea and fever for more than 3 days. Thirty-one of these patients were less than 5 years of age. Blood culture was positive in 7 out of 35 patients: culture of the stools was positive in all patients. Five of the 42 patients had presented an acute episode of Salmonella infection a few weeks earlier and had remained asymptomatic carriers until the new acute and severe episode of diarrhea. All patients were given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime-sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12 mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and fever.


RESULTS
Diarrhea and fever disappeared within less than 2 days in the group of patients given pefloxacin, even though in 6 patients the infecting Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients remained asymptomatic carriers of Salmonella in the group treated by pefloxacin vs 47% in the group without it. There was no difference in species of Salmonella between both groups. None of the patients treated by pefloxacin developed side-effects during the six months following its administration.


CONCLUSIONS
Short treatment by pefloxacin may be an alternative choice for treating severe Salmonella infections in children.
Moulin
F
F
Département de péditrie, hôpital Saint-Vincent-de-Paul, Paris, France.
Raymond
J
J
Bergeret
M
M
Iniguez
J L
JL
Habib
F
F
Chemillier-Truong
M
M
Legall
M A
MA
Badoual
J
J
Gendrel
D
D
D000658:Amoxicillin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002969:Clavulanic Acids / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015366:Pefloxacin / Q000627:therapeutic use*; D012480:Salmonella Infections / Q000188:drug therapy*; D017211:Treatment Failure; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D002969:Clavulanic Acids; D015366:Pefloxacin; D002443:Ceftriaxone; D000667:Ampicillin; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002439:Cefotaxime
Echecs du traitement antibiotique des salmonelloses sévères de l'enfant et utilisation des quinolones.