cefotaxime and Osteoarthritis

Neonatal osteoarticular infections remain rare, with an estimated incidence of 1 to 3 cases per 1000 admissions to Neonatal Intensive Care Units. It usually results from bacteraemia and may thus be induced by IV catheters. More rarely it is due to direct inoculation secondary to cutaneous damage, or extension of soft tissue infection. The particularity of bone vascularization in the newborn explains the frequency of abscess formation in the periosteum or in soft tissues. The main pathogen involved is S. aureus (3/4 of cases), followed by group B streptococci and enterobacteriacae. Infection consists mainly of localised and slowly progressing abscesses. However, multifocal and severe infection is possible, in particular when caused by an IV catheter. Ultrasonography is the best initial investigation, possibly leading to surgical care. Medical treatment must include 2 synergistic antistaphyloccocal antibiotics, possibly associated with cefotaxime. The outcome is generally favorable, but orthopaedic consequences may emerge if the growth plate is involved. Rare specific causes, such as syphilis or tuberculosis, should also be evoked, but the clinical context is generally helpful for the diagnosis.

Topics: Age Factors; Anti-Bacterial Agents; Bacterial Infections; Catheterization; Cefotaxime; Cross Infection; Drug Therapy, Combination; Enterobacteriaceae; Escherichia coli Infections; Humans; Incidence; Infant, Newborn; Intensive Care Units, Neonatal; Osteoarthritis; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus agalactiae; Treatment Outcome

Topics: Amoxicillin; Arthritis, Infectious; Cefotaxime; Cephalosporins; Female; Humans; Infant; Kingella kingae; Magnetic Resonance Imaging; Neisseriaceae Infections; Osteoarthritis; Penicillins; Tibia; Tomography, X-Ray Computed

Cefotaxime was administered to 20 patients suffering from severe bacterial infections. Four were newborn babies, seven were infants, and nine were children. The infections treated included 9 bronchopulmonary infections and 6 urinary tract infections. In 9 patients, the infecting organism was identified: E. coli (3), Klebsiella (2), Staphylococcus aureus (3), and Proteus (1). Except in one case, cefotaxime was administered alone at doses of 50 to 100 mg/kg every 12 hours. The route of administration was intramuscular. 4 patients had already received unsuccessful antimicrobial therapy. All patients were clinically cured. In those with pneumonia, the clinical and radiological response was very prompt; in urinary tract infections, the temperature returned to normal in less than 48 hours. The local and general tolerance was always good. It may be concluded from these results that cefotaxime, a new parenteral cephalosporin, is especially useful and should prove particularly effective in severe infectious conditions found in pediatric practice.

Topics: Adolescent; Bacterial Infections; Cefotaxime; Cephalosporins; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Lymphadenitis; Male; Osteoarthritis; Pneumonia; Skin Diseases, Infectious; Urinary Tract Infections