Effectiveness of antibiotic therapy in pediatric patients with cat scratch disease

Int J Clin Pharm. 2018 Dec;40(6):1458-1461. doi: 10.1007/s11096-018-0746-1. Epub 2018 Nov 16.

Abstract

Background Appropriate antibiotic treatment of cat scratch disease (CSD) in pediatrics is not well established. Objective The purpose of this study was to evaluate the response rates of antibiotic therapy in pediatrics with CSD. Methods The electronic medical records of a cohort of pediatric patients with confirmed diagnosis of CSD (2006-2016) were reviewed, retrospectively. Data collection included patient demographics, clinical and laboratory results, antibiotic treatment and follow-up evaluations. Results One hundred and seventy-five patients (aged 7.4 ± 4.4 years) had confirmed CSD. Azithromycin and trimethoprim/sulfamethoxazole (TMP/SMX) were the largest groups with documented effectiveness at follow-up visits. Resolution and improvement of CSD was observed in 51.4% and 61.5% of patients with azithromycin and TMP/SMX, respectively among those with follow-up assessment. The effectiveness of azithromycin and TMP/SMX was comparable (p = 0.56). Conclusion Azithromycin and TMP/SMX were most frequently prescribed antibiotics. Azithromycin appeared to be an appropriate option for the treatment of CSD. TMP/SMX may be considered as an alternative antibiotic when azithromycin cannot be used.

Keywords: Antibiotic therapy; Azithromycin; Cat scratch disease; Pediatrics; Trimethoprim/sulfamethoxazole.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use
  • Cat-Scratch Disease / drug therapy*
  • Cat-Scratch Disease / surgery
  • Child
  • Child, Preschool
  • Cohort Studies
  • Electronic Health Records
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Pediatrics
  • Retrospective Studies
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Azithromycin