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UNDER FOCUS : OUR PEDIATRIC THERAPY

During the growth stages a child most often suffers from some common disorders like bronchitis, cold, cough, and other infections.

Although the parents would make sure that their children are nourished in a hygienic atmosphere, right from their birth, the little ones are often affected by one health problem or the other. Any kind of health problem needs to be treated as soon as possible, because they might hamper the development of the child, if left untreated. Hence, it becomes important for the parents to know about the common disorders observed in children and the common medications for them.

ANTIBIOTICS

CEPHALOSPORINS IN ANTIBIOTIC THERAPY

(European Journal of Pediatrics, Volume 144, Number 6 / April, 1986): Cephalosporins belong to â- lactam antibiotics similar to penicillins. These antibacterial agents kill bacteria by preventing the cell wall synthesis. Similar to penicillin in their mode of action but they treat a broader range of bacterial infections. They have structural similarities to penicillin and many people with allergies to penicillins may also have allergic reactions to Cephalosporins. Oral cephalosporins are well tolerated by most children.

SPECTRUM OF ACTIVITY

ClassificationSpectrum
I Generation : Cefazolin, Cephalexin, Cefadroxil, CephradineGood activity against Gram +ve organisms; modest against Gram –ve organisms. Streptococci (except Penicillinase resistant), Staphylococci (except Methicillin resistant strain)
II Generation: Cefuroxime, Cefoxitin, Cefprozil, Cefaclor, Cefuroxime axetil, Loracarbef, Cefotetan, CefranideImproved activity against Gram –ve but much less active than III generation cephalosporins . Gram –ve organisms Enterococcus, Klebsiella, Haemophilus influenza; Not active against Gram +ve as I generation.
III Generation: Cefotaxime, Cefpodoxime, Ceftibuten, Cefdinir, Ceftriaxone, Ceftizoxime, Cefoperazone, CeftazidimeLess active against Gram +ve than I generation. More active against Enterobacteriaceae including â lactamase producing bacteria.
IV generation: Cefepime, CefpiromeExtended spectrum of activity than III generation cephalosporins and have increased stability against hydrolysis by â-lactamases


ANALGESICS AND ANTIPYRETICS


(PMID: 6359862 [PubMed - indexed for MEDLINE], Indian Joumal of Pediatrics, Volume 69--January, 2002)Fever and pain are the most common issues in pediatric patient management. Acetaminophen, aspirin, and dipyrone are the most commonly used drugs and are equivalent in their efficacy. The salicylates have anti-inflammatory effects making them appropriate for the treatment of patients with juvenile rheumatoid arthritis, but they are gastric irritants, may impair clotting, and, because of saturable kinetics, may lead to accumulation and toxicity. Acetaminophen is an effective antipyretic and analgesic with few side effects that is toxic only in massive overdose.

ANTITUSSIVES

(Handbook of Experimental Pharmacology- Pharmacology and Therapeutics of Cough, by Kian Fan Chung and John Widdicombe)Cough is a common symptom that can be self-limiting or persistent. Suppression of cough may be disease-specific or symptom-related. There has been a long tradition in acute cough usually due to upper respiratory tract infections to use symptom-related antitussives. In chronic cough, suppression of cough may be achieved by disease-specific therapies, but in many patients it may be necessary to use symptomatic antitussives. The efficacy of some over-the-counter symptomatic antitussives is often no better than that of a placebo. Many herbal extracts are known to show a true Antitussives action. Of nonherbal treatments, the few drugs such as bromhexine, and strong opoidal analgesics have shown effective antitussive action.

MULTIVITAMINS AND IRON SUPPLEMENTS

(Journal of the American Academy of Pediatrics, Vol. 114 No. 1 July 2004, pp. 86-93, Allsands.com) Daily Multivitamins with Iron are known to prevent Anemia in High-Risk Infants. The most common reason for iron deficiency anemia in infants and children is the inadequate supply of iron in the diet. Iron is a mineral the body needs in order to make red blood cells. Other causes include:
  • Breast feeding exclusively after six months of age
  • The introduction of cow's milk before twelve months of age or over reliance
  • Introducing solid foods later that six months of age
  • Lack of meat in the diet
  • Inadequate food intake
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