Archives of Disease in Childhood 2008;93:442-444
Archimedes
Question 1
IS THE FREQUENCY OF RECURRENT CHEST INFECTIONS, IN CHILDREN WITH CHRONIC NEUROLOGICAL PROBLEMS, REDUCED BY PROPHYLACTIC AZITHROMYCIN?
Correspondence to:
Royal Hospital for Sick Children, Edinburgh, UK; charlotte.kirk@luht.scot.nhs.uk
| The first 150 words of the full text of this article appear below. |
Fraser is an 8-year-old boy well known to everyone in A&E and the hospital. He has severe dystonic cerebral palsy as a result of his premature birth at 26 weeks’ gestation. Although he was ventilated for 5 weeks he did not develop chronic lung disease. He is gastrostomy fed and had a Nissen’s fundoplication 5 years ago. He has copious secretions and a poor cough reflex. These are made worse by nitrazepam which he requires for his dystonia. Evidence from previous barium studies and swallow assessments show that he chronically aspirates his secretions. He has no symptoms of upper airway obstruction.
Over the last year, he has had increasingly frequent lower respiratory tract infections, requiring admission and intra-venous antibiotics. His weight and height have fallen from the 10th to the 3rd percentile. A chest x ray shows chronic changes suggestive of underlying bronchiectasis and he is now colonised
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- Antibiotic Prophylaxis for Aspiration: The Limits of Extrapolation
- Eyal Cohen, et al.
- ADC Online, 23 Apr 2008 [Full text]
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