M. Yow, Nic E. Tengg
Apr 1, 1961
Citations
0
Influential Citations
14
Citations
Quality indicators
Journal
The Journal of pediatrics
Abstract
Summary 1. Two years of experience with the use of kanamycin sulfate in the management of serious infections in 140 infants and children is reported. The major clinical diagnoses were gastroenteritis, septicemia, pneumonia, pyoderma, subcutaneous abscess, deep abscess, osteomyelitis, omphalitis, thrombophlebitis, and a group of miscellaneous infections. Seventy-eight of the infections were due to Staphylococcus aureus , 28 to Escherichia coli , 5 to Klebsiella pneumoniae , 5 to Proteus species, and 1 to β streptococcus. In 23 cases an etiological diagnosis could not be established. The dosage of kanamycin used during the latter part of the study and presently employed is 12.5 to 50 mg. per kilogram per day. The drug was administered intramuscularly and locally. The duration of the therapy depended upon the nature of the infection. 2. Kanamycin was found to be a valuable drug in the treatment of serious infections in infants and children. Its advantages are that it is bactericidal, it is rapidly absorbed following intramuscular injection obviating intravenous therapy, it is active in vitro against the majority of strains of staphylococci, including hospital strains, and against many gram-negative bacilli ordinarily resistant to other antibiotics. 3. The experience gained in this study suggests that the following situations are important indications for the use of kanamycin: initial use in patients with extremely severe infections due to organisms that can be expected to respond to kanamycin; initial use for the treatment of less severe infections due to kanamycin-susceptible bacteria occurring in patients, such as premature infants, in whom a rapid progression of the disease process is anticipated; later use in patients with infections due to organisms found to be resistant to other antibiotics and sensitive to kanamycin. 4. The potential hazards in the use of kanamycin are nephrotoxicity and ototoxicity as have been reported in adults. There was no evidence that either was a problem in the group of children presented here, although large doses of kanamycin were used and in some instances the drug was administered for long periods. It should be kept in mind that there is increased risk of toxicity in patients who have diminished excretion of the drug due to pre-existing renal disease with decreased glomerular filtration rates.