The appropriateness of the current antibiotic empiric therapy based on thebacteria isolated from severely malnourished Jamaican children

We performed a retrospective audit of antimicrobial sensitivities of bacter ia isolated from children admitted with a diagnosis of malnutrition to the Tropical Metabolism Research Unit (TMRU), University, of the West Indies, b etween January 1995 and December 1999. There were 150 admissions for severe malnutrition to the TMRU during this period, which was approximately 50% f ewer than in a previous TMRU study done ten years ago, between 1984 and 198 9. In the present study, bacteraemia was documented in 10% of 150 severely malnourished children between 1 and 31 months of age. The most common organ isms isolated were coagulase-negative Staphylococci, which represented 40% of the total isolates. The micro-organisms grown were most likely to be sen sitive to amoxycillin/clavulanic acid. The current TMRU treatment protocol for severe malnutrition recommends use of crystalline penicillin plus genta micin as empirical antibiotic therapy. This study has provided valuable inf ormation suggesting that the current empiric antibiotic therapy may be inap propriate.