Trends in the susceptibility to antimicrobial drugs of common pathogens in childhood septicaemia in Nigeria: experience at the University of Maiduguri Teaching Hospital, Nigeria, 1991-1994.
From 1991 to 1994, Staphylococcus aureus, untyped Coliform spp. and Salmonella spp., other Enterobacteriaceae and other bacteria were isolated from 40.7%, 37.6%, 19.5% and 2.2%, respectively, of 225 confirmed cases of septicaemia in postneonatal infants and children. Overall, 98.9%, 72.8%, 70.8%, 87.9%, 4.3%, 79.3%, 42.6%, 17.6% and 40.6%, respectively, of pathogens were sensitive to oflaxacin, ceftazidime, cefuroxime, amoxicillincavulante, ampicillin, gentamicin, erythromycin, cotrimoxazole, and chloramphenicol. The resistance of S. aureus to ceftazidime and cloxacillin, and of Enterobacteriaceae to cefuroxime, has increased but multi-drug resistance is apparently not a major problem presently. Chloramphenicol has remained clinically an effective treatment for enteric fever, despite the high prevalence of in vitro resistance, and should remain the drug of choice. The sustained effectiveness of gentamicin should make it useful for combination with either a potentiated broad-spectrum penicillin or a second or third-generation cephalosporin for the treatment of septicaemia including those situations in which the causative bacteria has not yet been identified. Oflaxacin, although not normally recommended for use in children, could be a potential 'rescue' drug should multi-drug resistance become a serious problem; more clinical experience with its use in children is urgently needed.