Treatment of aspiration or tracheostomy-associated pneumonia in neurologically impaired children: effect of antimicrobials effective against anaerobic bacteria

Int J Pediatr Otorhinolaryngol. 1996 Apr;35(2):171-7. doi: 10.1016/0165-5876(96)01332-8.

Abstract

The purpose of the present study was to retrospectively review the antibiotic therapy of aspiration or tracheostomy-associated pneumonia in 57 neurologically impaired children (NIC). The antimicrobials used were either ticarcillin-clavulanate or clindamycin, which are effective against penicillin-resistant anaerobic bacteria, or ceftriaxone, which is less effective against these organisms. In those with aspiration pneumonia, a satisfactory clinical and microbiological response was observed in 8/9 (89%) patients who received ticarcillin-clavulanate, and 10/11 (91%) who received clindamycin with or without ceftazidime, as compared to 7/14 (50%) who received ceftriaxone (P < 0.05). For those who experienced tracheostomy-associated pneumonia, a positive response to therapy was observed in 5/6 (83%) who received ticarcillin-clavulanate, and 7/7 (100%) who received clindamycin with or without ceftazidime, as opposed to 4/10 (40%) who were treated with ceftriaxone (P < 0.05). The duration of fever was longer in both cases for those who received ceftriaxone. To summarize, this study illustrates the superiority of antimicrobials effective against penicillin-resistant anaerobic bacteria, as compared to an antibiotic without such coverage, in the therapy of aspiration or tracheostomy-associated pneumonia in NIC.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria, Anaerobic / drug effects*
  • Bacterial Infections / drug therapy*
  • Ceftazidime / administration & dosage
  • Ceftazidime / therapeutic use
  • Ceftriaxone / administration & dosage
  • Ceftriaxone / therapeutic use
  • Cephalosporins / administration & dosage
  • Cephalosporins / therapeutic use
  • Child
  • Child, Preschool
  • Clavulanic Acid
  • Clavulanic Acids / administration & dosage
  • Clavulanic Acids / therapeutic use
  • Clindamycin / administration & dosage
  • Clindamycin / therapeutic use
  • Female
  • Fever / drug therapy
  • Humans
  • Male
  • Penicillins / administration & dosage
  • Penicillins / therapeutic use
  • Pneumonia, Aspiration / drug therapy*
  • Pneumonia, Aspiration / microbiology
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / etiology
  • Retrospective Studies
  • Seizures / complications*
  • Ticarcillin / administration & dosage
  • Ticarcillin / therapeutic use
  • Tracheostomy / adverse effects*
  • Unconsciousness / complications*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Clavulanic Acids
  • Penicillins
  • Clavulanic Acid
  • Clindamycin
  • Ceftriaxone
  • Ceftazidime
  • Ticarcillin