Pefloxacin in steroid dependent and resistant idiopathic nephrotic syndrome.
Children with nephrotic syndrome who are either steroid dependent or resistant are difficult to manage. Ten children (age 8-14 years, mean 13.2 years) with idiopathic nephrotic syndrome (5 steroid dependent, 5 steroid resistant) formed the study group. All of them had received a course of cyclophosphamide at least six months previously and were now given pefloxacin in the dose of 200mg to 400mg twice daily (mean dose 2-4.6mg/kg/daily) for 4 to 8 weeks. They did not get steroid along with pefloxacin. After a mean follow up period of 18 weeks (12-20 weeks), 7 patients were in remission (2 complete, 5 partial), while 2 patients did not show any response; one patient discontinued pefloxacin within 2 weeks of start of therapy due to nausea and vomiting. One patient developed arthralgia and another discoloration of nails. There was a significant reduction in proteinuria after pefloxacin therapy (pre-3.6+/-2.02gm/24h; post 1.9+/-1.8gm/24h, p<0.006), and side effects were minimal and reversible. Thus for the subgroup of idiopathic nephrotic children who are steroid dependent or resistant and do not respond to a course of cyclophosphamide, pefloxacin could be helpful in inducing remission.
Sharma
R K
RK
Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. rksharma@sgpgi.ac.in
Sahu
K M
KM
Gulati
S
S
Gupta
A
A
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D015366:Pefloxacin / Q000627:therapeutic use*; D011446:Prospective Studies; D013256:Steroids
D000276:Adjuvants, Immunologic; D013256:Steroids; D015366:Pefloxacin