Research Article
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Year 2024, , 5 - 11, 05.07.2024
https://doi.org/10.69601/meandrosmdj.1491703

Abstract

References

  • Falagas ME, Tansarli GS, Karageorgopoulos DE, Vardakas KZ. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis. 2014; 20: 1170–5. doi: 10.3201/eid2007.121004
  • Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol. 2008; 29:1099–1106. doi: 10.1086/592412
  • Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother. 2008; 52:813–821. doi: 10.1128/AAC.01169-07
  • Falagas ME, Bliziotis IA. Pandrug-resistant Gram-negative bacteria: the dawn of the post-antibiotic era? Int J Antimicrob Agents. 2007; 29:630–636. doi: 10.1016/j.ijantimicag.2006.12.012
  • Bradley JS, Kauffman RE, Balis DA, Duffy CM, Gerbino PG, Maldonado SD, et al. Assessment of Musculoskeletal Toxicity 5 Years After Therapy With Levofloxacin. Pediatrics. 2014; 134: 1-8. doi: 10.1542/peds.2013-3636
  • Crawford-Faucher A. Levofloxacin Appears Safe and Effective for CAP in Children. Am Fam Physician. 2008; 77(6): 838-842.
  • Burkhardt JE, Walterspiel JN, Schaad UB. Quinolone arthropathy in animals versus children. Clin Infect Dis. 1997; 25(5): 1196–1204. doi: 10.1086/516119
  • Noel GJ, Blumer JL, Pichichero ME, Hedrick JA, Schwartz RH, et al. A randomized comparative study of levofloxacin versus amoxicillin/clavulanate for treatment of infants and young children with recurrent or persistent acute otitis media. Pediatr Infect Dis J. 2008; 27(6): 483–489. doi: 10.1097/INF.0b013e318168d2cb
  • Sendzik J, Lode H, Stahlmann R. Quinoloneinduced arthropathy: an update focusing on new mechanistic and clinical data. Int J Antimicrob Agents. 2009; 33(3): 194–200. doi: 10.1016/j.ijantimicag.2008.08.004
  • Patel SJ, Oliveira AP, Zhou JJ, Alba L, Furuya EY, Weisenberg SA, et al. Risk factors and outcomes of infections caused by extremely drug-resistant gram-negative bacilli in patients hospitalized in intensive care units. Am J Infect Control. 2014; 42(6): 626–631. doi: 10.1016/j.ajic.2014.01.027

Is It Safe To Use Levofloxacin For Treating Resistant Gram-Negatıve Bacterial Infections In The Pediatric Intensive Care Unit?

Year 2024, , 5 - 11, 05.07.2024
https://doi.org/10.69601/meandrosmdj.1491703

Abstract

Objective: Hospital-associated multidrug-resistant infections are currently on the rise. Widespread resistance to antibiotics and limited therapeutic options make it a challenge to eradicate these infections. Therefore, the use of different antibiotics was increased in pediatric intensive care (PICU). Fluoroquinolones belong to a class of broad-spectrum antimicrobials, and their use in children has not been associated with any known clinical complications. In this single-centre retrospective study, we aimed to evaluate the effects, results, and safety of levofloxacin treatment.

Materials and Methods: A retrospective, single-center study was conducted at a local tertiary hospital involving 22 patients who were treated with levofloxacin in the PICU from July to December 2021. Levofloxacin was initiated at a dose of 10mg/kg twice daily intravenously for 14-21 days. The study examined and evaluated various factors related to the patients, including their demographic characteristics, medical history, comorbidities, length of stay, need for mechanical ventilation support, laboratory results, type of infection/microorganism, duration of treatment, treatment response and adverse effects, morbidity and mortality.

Results: Stenotrophomonas maltophilia13(59.1%) and Pseudomonas aeruginosa9(40.9%) were detected in included patients who had levofloxacin treatment 20(90.9%) of their infections were eradicated. The mortality rate was found to be 13.6%, and 19 patients (86.4%) were successfully treated. No complications related to levofloxacin were detected during the treatment period. The duration of levofloxacin treatment in patients with eradication of gram negative bacteria was 21 days (range: 14-27 days), compared to 12 days (range: 10-14 days) in patients without eradication. This difference was found to be statistically significant (p=0.007).

Conclusions: Due to the challenge of eradicating infections and the rising antibiotic resistance, it may be necessary to use antibiotics that are not typically prescribed to children or to develop new drug categories. Therefore, there is a need for more multicenter, randomized controlled, and long-term observational studies to evaluate the efficacy of different and new groups of antibiotics, including levofloxacin, in treating gram-negative bacterias.

References

  • Falagas ME, Tansarli GS, Karageorgopoulos DE, Vardakas KZ. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis. 2014; 20: 1170–5. doi: 10.3201/eid2007.121004
  • Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol. 2008; 29:1099–1106. doi: 10.1086/592412
  • Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother. 2008; 52:813–821. doi: 10.1128/AAC.01169-07
  • Falagas ME, Bliziotis IA. Pandrug-resistant Gram-negative bacteria: the dawn of the post-antibiotic era? Int J Antimicrob Agents. 2007; 29:630–636. doi: 10.1016/j.ijantimicag.2006.12.012
  • Bradley JS, Kauffman RE, Balis DA, Duffy CM, Gerbino PG, Maldonado SD, et al. Assessment of Musculoskeletal Toxicity 5 Years After Therapy With Levofloxacin. Pediatrics. 2014; 134: 1-8. doi: 10.1542/peds.2013-3636
  • Crawford-Faucher A. Levofloxacin Appears Safe and Effective for CAP in Children. Am Fam Physician. 2008; 77(6): 838-842.
  • Burkhardt JE, Walterspiel JN, Schaad UB. Quinolone arthropathy in animals versus children. Clin Infect Dis. 1997; 25(5): 1196–1204. doi: 10.1086/516119
  • Noel GJ, Blumer JL, Pichichero ME, Hedrick JA, Schwartz RH, et al. A randomized comparative study of levofloxacin versus amoxicillin/clavulanate for treatment of infants and young children with recurrent or persistent acute otitis media. Pediatr Infect Dis J. 2008; 27(6): 483–489. doi: 10.1097/INF.0b013e318168d2cb
  • Sendzik J, Lode H, Stahlmann R. Quinoloneinduced arthropathy: an update focusing on new mechanistic and clinical data. Int J Antimicrob Agents. 2009; 33(3): 194–200. doi: 10.1016/j.ijantimicag.2008.08.004
  • Patel SJ, Oliveira AP, Zhou JJ, Alba L, Furuya EY, Weisenberg SA, et al. Risk factors and outcomes of infections caused by extremely drug-resistant gram-negative bacilli in patients hospitalized in intensive care units. Am J Infect Control. 2014; 42(6): 626–631. doi: 10.1016/j.ajic.2014.01.027
There are 10 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Research Article
Authors

Hatice Feray Arı 0000-0002-2208-2524

Murat Arı 0000-0002-1504-7050

Ümüt Altuğ 0000-0002-6864-377X

Early Pub Date June 30, 2024
Publication Date July 5, 2024
Published in Issue Year 2024

Cite

EndNote Arı HF, Arı M, Altuğ Ü (July 1, 2024) Is It Safe To Use Levofloxacin For Treating Resistant Gram-Negatıve Bacterial Infections In The Pediatric Intensive Care Unit?. Meandros Medical And Dental Journal 25 1 5–11.