RESUMEN
Although outpatient parenteral antimicrobial therapy (OPAT) is practiced internationally, there is a paucity of data regarding outcomes of paediatric OPAT. A retrospective analysis, of 3 years experience (January 2010 to 2013) was performed at a tertiary paediatric Respiratory unit. There were 362 OPAT courses administered to 32 children, of which 30 had cystic fibrosis and the remaining two had recurrent pneumonia. A total of 3,688 days of antibiotics were administered. The median age was 8.8 years (range 2.75 - 17.8 years). Sixteen (50%) were male. Each child received an average of 11 courses and median duration of OPAT was 10 days (range 2-21 days). Tobramycin was the commonest antimicrobial prescribed, with ceftazidime second. During this period, there was one readmission (0.3%) post discharge and 3 (2%) portocath infections. All patients attended for weekly review and laboratory monitoring. OPAT appears safe, effective and reduces the need for inpatient beds.
Asunto(s)
Atención Ambulatoria/métodos , Antiinfecciosos/administración & dosificación , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Adolescente , Atención Ambulatoria/estadística & datos numéricos , Niño , Preescolar , Femenino , Humanos , Irlanda/epidemiología , Masculino , Pacientes Ambulatorios , Infecciones del Sistema Respiratorio/epidemiología , Estudios RetrospectivosRESUMEN
Allergic bronchopulmonary aspergillosis (ABPA) can cause a significant clinical deterioration in patients with cystic fibrosis. There is very little research in the current literature with regard to alternatives for treatment, apart from long courses of steroids. We conducted a retrospective review of all our patients with ABPA treated with the antifungal voriconazole and found there was a significant drop in IgE levels post treatment as well as a decrease in steroid dosing. The improvement in FEV was not statistically significant; however there was a very wide variation in pre-treatment levels.
Asunto(s)
Antifúngicos/uso terapéutico , Aspergilosis Broncopulmonar Alérgica/tratamiento farmacológico , Fibrosis Quística/complicaciones , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , Adolescente , Aspergilosis Broncopulmonar Alérgica/etiología , Intervalos de Confianza , Fibrosis Quística/fisiopatología , Femenino , Volumen Espiratorio Forzado , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/efectos de los fármacos , Masculino , Estudios Retrospectivos , VoriconazolRESUMEN
Despite its health implications, the fibre intake of Irish children is unknown. The North/South Ireland Food Consumption Survey indicated that 77% of Irish adults do not consume adequate fibre and surveys of children and adolescents in Canada and Sweden have confirmed suboptimal fibre intake in these groups. This study undertook to assess fibre intake and the incidence of constipation in Irish children aged 5-8 years. Children admitted to hospital with an acute self-limiting medical illness were included in the study. Three day food diaries were recorded on discharge from hospital. The presence of constipation was ascertained Seventy six per cent of 135 children s diets did not contain adequate fibre. The incidence of constipation was 13.6% in those with inadequate fibre intake as opposed to 6% in those with adequate fibre intake. Poor dietary fibre needs to be addressed in the context of health promotion and disease prevention involving parents, health care professionals and government public policy.