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Ventriculitis caused byKlebsiella pneumoniae successfully treated with pefloxacin in a neonate

Ventrikulitis durchKlebsiella pneumoniae bei einem Neugeborenen. Erfolgreiche Behandlung mit Pefloxacin

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Summary

Pefloxacin was applied to a newborn suffering from ventriculitis caused byKlebsiella pneumoniae after failure of routine antibiotics. Treatment was successful. Blood and CSF levels were high, thus documenting good CSF penetration. In addition to this case report, a review of the literature regarding seven neonates with CNS infection treated with fluoroquinolones and from whom CSF levels were obtained, is presented. In conclusion, due to their excellent activity against gram-negative microorganisms, fluoroquinolones may be considered in the treatment of neonatal CNS infections if the pathogen is resistant to routinely used antibiotics. Only limited experience is available with fluoroquinolones in pediatric patients given their potential for cartilage toxicity in young animals.

Zusammenfassung

Nach Versagen von Routineantibiotika wurde Pefloxacin eingesetzt, um eine durchKlebsiella pneumoniae verursachte Ventrikulitis bei einem Neugeborenen zu behandeln. Die Therapie war erfolgreich. Im Blut und im Liquor cerebrospinalis fanden sich hohe Spiegel von Pefloxacin. Die hohe Penetrationsrate von Pefloxacin in den Liquor ist damit dokumentiert. In einer Literaturübersicht werden sieben weitere Fälle von ZNS-Infektionen bei Neugeborenen dargestellt, die unter Bestimmung der Liquorspiegel mit Fluorochinolonen behandelt wurden. Fluorochinolone kommen wegen ihrer hohen Aktivität gegen gramnegative Bakterien für die Behandlung einer gegen herkömmliche Antibiotika resistenten gramnegativen ZNS-Infektion bei Neugeborenen in Frage. Die Erfahrungen mit Fluorochinolonen sind bei pädiatrischen Patienten jedoch wegen der Möglichkeit einer bei jungen Tieren beobachteten Knorpelschädigung begrenzt.

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Authors and Affiliations

  1. Dept. of Neonatology, Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv

    Nehama Linder M.D., J. Kuint M.D. & B. Reichman M.D.

  2. Clinical Microbiology Laboratory, Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv

    N. Keler M.D., Ph. D.

  3. Infectious Disease Unit, Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv

    G. Keren M.D.

  4. Pediatric Infectious Disease Unit, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel

    R. Dagan M.D.

Authors
  1. Nehama Linder M.D.
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  2. J. Kuint M.D.
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  3. B. Reichman M.D.
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  4. N. Keler M.D., Ph. D.
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  5. G. Keren M.D.
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  6. R. Dagan M.D.
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Linder, N., Kuint, J., Reichman, B. et al. Ventriculitis caused byKlebsiella pneumoniae successfully treated with pefloxacin in a neonate. Infection 22, 210–212 (1994). https://doi.org/10.1007/BF01716707

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  • DOI: https://doi.org/10.1007/BF01716707

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