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        "titulo" => "Control of a school outbreak of meningococcal b infection through chemoprophylaxis with azithromycin and ciprofloxacin"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comprobar la efectividad de la azitromicina como medicamento quimioprofil&#225;ctico de la enfermedad meningoc&#243;cica en preescolares&#44; y la seguridad del ciprofloxacino en ni&#241;os de 6 a 16 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En un brote escolar de enfermedad meningoc&#243;cica&#44; ante el fallo previo de la rifampicina&#44; se realiz&#243; un segundo ciclo de quimioprofilaxis con azitromicina en educaci&#243;n infantil &#40;99 ni&#241;os de 3 a 5 a&#241;os&#41; y con ciprofloxacino en educaci&#243;n primaria y secundaria &#40;795 ni&#241;os de 6 a 16 a&#241;os&#41; y en los 58 adultos del centro&#46; La eficacia de la quimioprofilaxis se comprob&#243; mediante los registros de ingresos por enfermedad meningoc&#243;cica&#44; el sistema EDO y las bajas escolares&#44; y la seguridad del ciprofloxacino mediante encuestas dirigidas a los padres y a los pediatras de la zona de influencia del colegio&#44; destinadas a recoger la incidencia de efectos adversos osteoarticulares&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El brote se control&#243; con la quimioprofilaxis establecida&#46; Se recogieron 764 encuestas &#40;tasa de respuesta&#44; 89&#44;5&#37;&#41;&#46; La incidencia de artralgias tras ciprofloxacino fue del 0&#44;9&#37; en los ni&#241;os y del 3&#44;3&#37; en adultos&#46; Todas fueron leves y autolimitadas sin tratamiento&#44; menos un caso &#40;en el grupo de adultos&#41; en que persist&#237;an un mes tras la quimioprofilaxis pero de naturaleza tan leve que no hab&#237;a consultado a su m&#233;dico&#46; S&#243;lo 3 ni&#241;os hab&#237;an realizado consulta m&#233;dica por las artralgias&#44; por lo que la incidencia detectada por el sistema habitual de farmacovigilancia hubiera sido de 0&#44;4&#37; en los ni&#241;os y 0&#37; en los adultos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La azitromicina fue eficaz en el control del brote en los ni&#241;os de 3-5 a&#241;os&#46; El ciprofloxacino fue seguro y eficaz&#44; sin ning&#250;n efecto osteoarticular grave o persistente en ni&#241;os&#44; y con una incidencia de artralgias menor que en los adultos&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the efficacy of azithromycin as a chemoprophylactic agent in meningococcal disease in pre-school aged children&#44; and the safety of ciprofloxacin in children aged 6-16 years old&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">After classic chemoprophylaxis with rifampicin failed to control a school outbreak of meningococcal disease in Cantabria &#40;Spain&#41;&#44; a second cycle of chemoprophylaxis was administered in the school&#46; Azithromycin was administered in the nursery level &#40;99 children&#44; aged 3-5 years old&#41; and ciprofloxacin was administered in the primary and secondary levels &#40;795 children&#44; aged 6-16 years old&#41; and in the school&#39;s adult personnel &#40;58 persons&#41;&#46; The efficacy of chemoprophylaxis was studied through records of cases of meningococcal disease&#44; the mandatory disease reporting system&#44; and the school&#39;s absences&#46; The safety of ciprofloxacin was studied using a questionnaire designed to determine the incidence of adverse osteoarticular effects&#44; which was distributed to parents&#44; school personnel and pediatricians within the school&#39;s area&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The chemoprophylaxis administered controlled the outbreak&#46; We collected 764 questionnaires &#40;response rate&#58; 89&#46;5&#37;&#41;&#46; The incidence of arthralgia after ciprofloxacin was 0&#46;9&#37; in children and 3&#46;3&#37; in adults&#46; All were mild and self-limiting without specific treatment&#44; except in one patient &#40;in the adult group&#41; in whom arthralgia was present 1 month after prophylactic treatment&#46; However&#44; the arthralgia was so mild that the patient had not consulted her physician&#46; Only three children had sought medical advice for arthralgia&#46; Consequently&#44; the incidence that would have been detected by the Spanish pharmacovigilance system would have been 0&#46;4&#37; in children and 0&#37; in adults&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Azithromycin was effective in controlling the outbreak in children aged between 3 and 5 years&#46; Ciprofloxacin was safe and effective&#44; with no serious or persistent osteoarticular effects in children&#46; The incidence of arthralgia was lower in children that in adults&#46;</p>"
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Vol. 53. Núm. 5.
Páginas 412-417 (noviembre 2000)
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Vol. 53. Núm. 5.
Páginas 412-417 (noviembre 2000)
Acceso a texto completo
Control de un brote escolar de enfermedad meningocócica serogrupo B mediante quimioprofilaxis con azitromicina y ciprofloxacino
Control of a school outbreak of meningococcal b infection through chemoprophylaxis with azithromycin and ciprofloxacin
Visitas
4421
A. González de Aledo Linos
Autor para correspondencia
aaledo@cantabria.org

Correspondencia: Valdenoja, 46, 7.° 39012 Santander (Cantabria).
, J. García Merino
Sección de Promoción de la Salud. Dirección General de Sanidad de Cantabria. Santander
Este artículo ha recibido
Información del artículo
Abstract
Objetivos

Comprobar la efectividad de la azitromicina como medicamento quimioprofiláctico de la enfermedad meningocócica en preescolares, y la seguridad del ciprofloxacino en niños de 6 a 16 años.

Material y métodos

En un brote escolar de enfermedad meningocócica, ante el fallo previo de la rifampicina, se realizó un segundo ciclo de quimioprofilaxis con azitromicina en educación infantil (99 niños de 3 a 5 años) y con ciprofloxacino en educación primaria y secundaria (795 niños de 6 a 16 años) y en los 58 adultos del centro. La eficacia de la quimioprofilaxis se comprobó mediante los registros de ingresos por enfermedad meningocócica, el sistema EDO y las bajas escolares, y la seguridad del ciprofloxacino mediante encuestas dirigidas a los padres y a los pediatras de la zona de influencia del colegio, destinadas a recoger la incidencia de efectos adversos osteoarticulares.

Resultados

El brote se controló con la quimioprofilaxis establecida. Se recogieron 764 encuestas (tasa de respuesta, 89,5%). La incidencia de artralgias tras ciprofloxacino fue del 0,9% en los niños y del 3,3% en adultos. Todas fueron leves y autolimitadas sin tratamiento, menos un caso (en el grupo de adultos) en que persistían un mes tras la quimioprofilaxis pero de naturaleza tan leve que no había consultado a su médico. Sólo 3 niños habían realizado consulta médica por las artralgias, por lo que la incidencia detectada por el sistema habitual de farmacovigilancia hubiera sido de 0,4% en los niños y 0% en los adultos.

Conclusiones

La azitromicina fue eficaz en el control del brote en los niños de 3-5 años. El ciprofloxacino fue seguro y eficaz, sin ningún efecto osteoarticular grave o persistente en niños, y con una incidencia de artralgias menor que en los adultos.

Key words:
Meningococcus
Chemoprophylaxis
Azithromycin
Ciprofloxacin
Resumen
Objective

To assess the efficacy of azithromycin as a chemoprophylactic agent in meningococcal disease in pre-school aged children, and the safety of ciprofloxacin in children aged 6-16 years old.

Methods

After classic chemoprophylaxis with rifampicin failed to control a school outbreak of meningococcal disease in Cantabria (Spain), a second cycle of chemoprophylaxis was administered in the school. Azithromycin was administered in the nursery level (99 children, aged 3-5 years old) and ciprofloxacin was administered in the primary and secondary levels (795 children, aged 6-16 years old) and in the school's adult personnel (58 persons). The efficacy of chemoprophylaxis was studied through records of cases of meningococcal disease, the mandatory disease reporting system, and the school's absences. The safety of ciprofloxacin was studied using a questionnaire designed to determine the incidence of adverse osteoarticular effects, which was distributed to parents, school personnel and pediatricians within the school's area.

Results

The chemoprophylaxis administered controlled the outbreak. We collected 764 questionnaires (response rate: 89.5%). The incidence of arthralgia after ciprofloxacin was 0.9% in children and 3.3% in adults. All were mild and self-limiting without specific treatment, except in one patient (in the adult group) in whom arthralgia was present 1 month after prophylactic treatment. However, the arthralgia was so mild that the patient had not consulted her physician. Only three children had sought medical advice for arthralgia. Consequently, the incidence that would have been detected by the Spanish pharmacovigilance system would have been 0.4% in children and 0% in adults.

Conclusions

Azithromycin was effective in controlling the outbreak in children aged between 3 and 5 years. Ciprofloxacin was safe and effective, with no serious or persistent osteoarticular effects in children. The incidence of arthralgia was lower in children that in adults.

Palabras clave:
Meningococo
Quimioprofilaxis
Azitromicina
Ciprofloxacino
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