Day 1 :
Sophia’s Children’s Hospital, Netherlands
Keynote: Neonatal Clinical Pharmacology
Time : 10:00-10:45
Prof Karel Allegaert, MD, PhD is a pediatrician-neonatologist and clinical pharmacologist. He is associate Professor at the Department of Development and Regeneration, Biomedical Sciences KU Leuven (20%) and Consultant at the Departments Intensive Care and Pediatric Surgery, and Neonatology, Erasmus MC Rotterdam (80%). His clinical research has a focus on perinatal and pediatric pharmacology and pediatric pain management and has resulted in more than 360 PubMed publications.
Drug therapy is a very powerful tool to improve the medical outcome of neonates. Yet, caregivers still commonly prescribe drug formulations and dosing regimens that initially were developed for adults, by extrapolating from indications documented in adult medicine and based on the pathophysiology proper to the adult patient. Human growth and development consists of a sequence of physiologic events that relate to both somatic growth as well as (neurobehavioral) maturation since weight gain co-exists but is not similar to maturation. These maturational physiological trends are further affected by either treatment modalities [e.g. whole body cooling, extracorporeal membrane oxygenation (ECMO) or pharmacotherapy] used or pathophysiological processes or co-morbidities [e.g. perinatal asphyxia, cardiopathy, sepsis, renal failure, patent ductus arteriosus]. All these changes, both maturational (e.g. age, weight) and pathophysiological result in extensive variability within the first months of postnatal life and make neonatal pharmacotherapy as diverse as the neonates taken care for in our units.
The aim of administering any compound is to reach effective treatment of a given disease while avoiding disproportional side-effects. Clinical pharmacology aims to predict drug-specific (side)-effects based on pharmacokinetics and pharmacodynamics. Pharmacokinetics (PK, absorption, distribution and subsequent elimination, either through metabolic elimination or through primary renal elimination, ADME) hereby estimate the relationship between a drug concentration at a specific site (e.g. plasma, cerebrospinal fluid) and time (‘what the body does to the drug’). Pharmacodynamics (PD) estimates the relationship between a drug concentration and (side)-effects (‘what the drug does to the body’).
Children’s Hospital Baqai Medical University, Pakistan
Keynote: Frequency and antimicrobial susceptibility pattern of microorganisms isolated from hospitalized infantile burn cases in a tertiary care hospital
Time : 11:05-11:50
Jalal Uddin Akber graduated from Liaquat Medical College in 1988 and Presently working as Chairman and Head of Pediatrics at Children’s Hospital Baqai Medical University, Karachi, since last 7 years. He is also working as consultant pediatrician at Patel hospital Karachi for last 18 years and a member of plastic surgery and burn unit. Dr. Jalal uddin Akber is a master trainer for different project of UNICEF, WHO and Pakistan Pediatric Association. He is a member of Pakistan Pediatrics Association, American Academic of Pediatrics as well as Polio Eradication Certification Committee, Government of Pakistan. He has been a guest speaker in more than 100 national and international conferences, seminars and workshops.
Objective: The aim of this study was to determine the frequency of organisms and their antimicrobial sensitivity pattern in infantile burn.
Methods: This retrospective study was conducted at the plastic surgery, burn unit of Patel Hospital during period of 7 years from January 2007 to December 2013. Children aged one year or less at the time of admission were included in the study. SPSS 21 version was used for statistical analysis.
Results: Total 789 pediatric burn patients were admitted in Patel Hospital during January 2007 to December 2013, in which 106 were infants. Eighty three (78.3%) infants had scald burn, 21 (19.8%) had fire burn and 2 (1.9%) had chemical burn. Out of 106 infantile burn cases, 28 (26.4%) had growth of organisms in wound cultures. Initially at the time of admission only 2 (7%) of infants had growth of organisms in wound cultures but on subsequent cultures the growth of organisms increased. Single organism was isolated in wound cultures of 9 (32.1%) patients, while two organisms were found in 8 (28.6%) and three organisms were found in 11 (39.3%) infants. The commonest organisms present both in scald and fire burn were Staphylococcus aureus 17 (60.7%) followed by Acinetobacter species 14 (50%) and Pseudomonas aeruginosa 13 (46.4%) respectively. If we see the sensitivity pattern, Staphylococcus aureus was 100% sensitive to vancomycin and linezolid followed by fusidic acid 47%. If we see the culture and sensitivity pattern of Pseudomonas aeruginosa, Acinetobacter species and Klebsiella species all were 100% sensitive to polymyxin B. While Providencia species and Proteus species were 100% sensitive to cefoperazone + sulbactam and meropenem.
Conclusion: This study high lights that Staphylococcus aureus, Acinetobacter species and Pseudomonas aeruginosa are the common organisms in infantile burn. While vancomycin and polymyxin B are the effective empirical therapy in our setup. Antibiotic resistance due to inappropriate use of drugs is a common finding in our environment and medical staff must be educated regarding the rational use of antibiotics. Wound swabs should be performed in all cases.