Changing patterns in sensitivity of causative organisms of septicaemia in children: the need for quinolones

Abstract

A review of the pattern and antibiotic sensitivities of blood culture isolates over a 3-year period in children presenting to the Paediatric Unit of Ahmadu Bello University Teaching Hospital. Kaduna is reported. Positive blood culture isolates were obtained in 26.9% of 1.982 children. The most prevalent isolates were Staphylococcus aureus (59.9%), Escherichia coli (16.9%) and Klebsiella (16.3%). There was a striking paucity of isolation of Salmonella typhi (1.3%) and Streptococcus. Sensitivity to commonly used drugs like ampiciilin/cloxacillin. genticin, ceftazidime and chloramphenicol were low (8.0-50.0%), with a corresponding delayed fever resolution and prolonged hospital stay. 31.0-83.3% of the isolates were highly sensitive to pefloxacin, norfloxacin and ofloxacin, which were not generally recommended for use in paediatric patients. In two patients with no response to commonly used antibiotics, use of quinolones lysed their fever within 48 hours. This change of antibiotic sensitivity patterns calls for a thorough investigation into the potential role of these quinolones in paediatric chemotherapeutics either singly or in appropriate combinations with existing antibiotics.