Treatment of Anaerobic Infections in Children with Metronidazole

Publisher Website
Google Scholar
Abstract
The tolerance and efficacy of metronidazole were studied in 15 pediatric patients who had anaerobic infection; 5 had soft tissue abscess, 4 aspiration pneumonia, 3 intracranial abscess and 3 chronic sinusitis. Bacterial isolates were obtained (3 isolates/patients); 40 were anaerobes and included 17 Bacteroides sp (8 isolates of B. melaninogenicus group, 5 of B. fragilis group, 3 B. oralis and 1 Bacteroides sp.), 16 anaerobic cocci and 6 Fusobacterium nucleatum. Metronidazole was given i.v. at a dose of 30 mg/kg/day or orally in a dose of 40-50 mg/kg/day. The length of therapy was 14-52 days (average 26 days). Of the patients, 7 received initial parenteral therapy for 5-21 days (average 11.6 days) and subsequently received oral therapy. The minimal inhibitory concentration of 38 of the 41 anaerobic isolates (93%) was .ltoreq. 2 .mu.g/ml. The mean peak concentration of metronidazole on the 3rd day of therapy was 24.2 .mu.g/ml (range 15.2-30 .mu.g/ml); the mean trough was 7.2 .mu.g/ml (range 4-11.6 .mu.g/ml). No local or systemic adverse reactions were noted. A good response to therapy with a complete cure occurred in 14 of the 15 children. A fair response was achieved in 1 patient. Apparently, metronidazole is effective and safe in the treatment of serious anaerobic infection in children.