Morganella morganii: bacteria inusual en líquido articular / Morganella morganii: An unusual bacterium in joint effusions

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Meropenem en el tratamiento empírico de infecciones moderadas o graves en niños hospitalizados de 3 a 12 meses y de 1 a 14 años de edad / Meropenem as empirical therapy in moderate to severe infections in hospitalized children aged 3 to 12 months and 1 to 14 years

El objetivo del estudio fue evaluar la dosis, la eficacia y la tolerabilidad del tratamiento con meropenem en pacientes pediátricos con infecciones moderadas a graves. Se realizó un estudio observacional, múlticéntrico y prospectivo en 258 pacientes. Fueron analizados y subdivididos en dos grupos (81 menores de 1 año y 177 entre 1 y 14 años de edad), con seguimiento y control a las 48 horas de comenzar el tratamiento, al final de éste y a la semana de haberlo finalizado. Las infecciones eran de adquisición nosocomial en el 37,5% de los pacientes entre 1 y 14 años, y en el 79,7% de los menores de 1 año (p <0.001). El 79% recibieron 20 mg/kg/8 h de meropenem y un 43,8% recibieron tratamiento combinado con antifúngicos, glucopéptidos o ambos. El 77,4% mostró mejoría clínica a las 48 horas, el 74,2% curaron clínicamente al final del tratamiento y el 77,5% estaban clínicamente asintomáticos a la semana de finalizarlo. La evolución clínica a la curación fue similar en los dos grupos de edad. La erradicación microbiológica se observó en un 76,8%, sin diferencias significativas entre ambos grupos. No se detectaron efectos adversos importantes, a excepción de una pancitopenia en una paciente con protocolo por trasplante hepático al tercer día de tratamiento (AU)

The objective of this study was to evaluate the clinical efficacy, dose and tolerability of treatment with meropenem in children with moderate to severe infections. An observational, multicenter, prospective study of 258 children was conducted. Two cohorts (81 under the age of 1 year, and 177 aged 1 to 14 years) were followed up at 48 hours, at the end of treatment, and 1 week later. Nosocomial infections were present in 37.5% of the children aged 1 to 14 years, and in 79.7% of those younger than 1 year of age (p <0.001). A total of 79% received 20 mg/kg/8 h of meropenem; 43.8% received combination treatment with antifungal agents, glycopeptides or both. At 48 hours, 77.4% showed a clinical improvement; 74.2% were clinically cured at the end of treatment, and 77.5% at 1 week after the end of treatment. The clinical outcome was similar in both groups. Eradication or negative control cultures were found in 76.8%, with no difference between the two age groups. No major adverse events were reported, except for one case of pancytopenia after 2 days of treatment in a patient with a transplanted liver (AU)

[Meropenem as empirical therapy in moderate to severe infections in hospitalized children aged 3 to 12 months and 1 to 14 years]. / Meropenem en el tratamiento empírico de infecciones moderadas o graves en niños hospitalizados de 3 a 12 meses y de 1 a 14 años de edad.

The objective of this study was to evaluate the clinical efficacy, dose and tolerability of treatment with meropenem in children with moderate to severe infections. An observational, multicenter, prospective study of 258 children was conducted. Two cohorts (81 under the age of 1 year, and 177 aged 1 to 14 years) were followed up at 48 hours, at the end of treatment, and 1 week later. Nosocomial infections were present in 37.5% of the children aged 1 to 14 years, and in 79.7% of those younger than 1 year of age (p < 0.001). A total of 79% received 20 mg/kg/8 h of meropenem; 43.8% received combination treatment with antifungal agents, glycopeptides or both. At 48 hours, 77.4% showed a clinical improvement; 74.2% were clinically cured at the end of treatment, and 77.5% at 1 week after the end of treatment. The clinical outcome was similar in both groups. Eradication or negative control cultures were found in 76.8%, with no difference between the two age groups. No major adverse events were reported, except for one case of pancytopenia after 2 days of treatment in a patient with a transplanted liver.