Cefuroxime therapy for bacteremic soft-tissue infections in children
W. J. Barson, M. A. Miller, M. J. Marcon, M. M. Hribar, M. T. Brady, D. L. Pacini and D. A. Powell
Although it is used extensively in Europe, there is a limited amount of
published data concerning pediatric clinical experience with cefuroxime in
the United States. Thirty-six children, ranging from 3.5 to 57 months of
age, received intravenous cefuroxime (75 mg/kg/day in three divided doses)
for soft-tissue infections of the face or epiglottis. Infections treated
included preseptal (19 patients) and buccal (13 patients) cellulitis and
epiglottitis (four patients). Blood cultures were positive in 22 patients,
yielding Haemophilus influenzae type b in 17 (four were
beta-lactamase-positive), Streptococcus pneumoniae in four; and
beta-lactamase-positive, nontypable H influenzae in one. An additional five
patients with buccal cellulitis had negative blood cultures but H
influenzae type b antigenuria. A satisfactory clinical response was noted
in all patients, and repeated blood cultures performed in initially
bacteremic patients were sterile. Cefuroxime therapy was well tolerated,
and abnormal laboratory results were infrequent, except for absolute
granulocytopenia (granulocytes, less than 1,500/cu mm), which occurred in
six patients but could not be ascribed to a drug effect because of the
uncontrolled design of our study. Treatment with cefuroxime appears to be a
safe and effective therapy for pediatric soft-tissue infections due to H
influenzae and S pneumoniae.
