HAEMOPHILUS-INFLUENZAE INFECTIONS IN CHIL DREN

Important pathogen: Haemophilus influenzae and Streptococcus pneumonia e are the leading causes of severe bacterial infections in children, c ausing purulent meningitis, epiglotitis, cellulitis, osteoarthritis, o ccult bacteremia. After vaccination: Widespread vaccinations have redu ced the frequency of severe Haemophilus infuenzae b infections. When t hey do occur, the prognosis depends on early diagnosis and initial ant ibiotherapy. Therapeutic strategy: Recent epidemiological data has mod ified current strategies. For meningitis, the prevalence of amoxicilli n-resistant H. influenzae b has led to the use of third generation cep halosporins by intravenous injections as first intention treatment whi ch is continued if the strain does not secrete beta-lactamase. A two-d rug regimen may be systematically used in children (beta-lactamin + am inoglycoside). For other infections, one must take into account the ri sk of amoxicillin-resistance and the possibility of other causal germs . (C) 1997, Masson, Paris.