High incidence of drug fever due to antibiotics used in treatment of brain abscess in children

Abstract

Background: Brain abscess is not uncommon in Thailand. Treatment of brain abscess consists of surgery and antibiotics using high dose and long duration. The problem of drug fever in the treatment of brain abscess has never been reported in children. Objective: To review the epidemiology of drug fever in children with brain abscess.Methods: Seventy-five infants and children with brain abscess were analyzed retrospectively. Results: The mean age was 7.9 ± 4.4 years. The male-to-female ratio was 1.3:1. The most common predisposing factor was congenital heart disease. The most common organisms in congenital heart disease and chronic otitis media were Streptococci and Proteus respectively. The overall mortality rate was 2.6 %. The incidences of drug fever in the antibiotic regimens using penicillin plus chloramphenicol, cefotaxime plus metronidazole and regimens with cloxacillin were 44.9, 30.8 and 50.0 %, respectively. The overall incidence of drug fever was 38.7 %. The mean onset of drug fever was after 19.4 ± 6.3 days. Most of the patients also had at least one allergic drug reaction such as drug rash, eosinophilia and neutropenia (93.1 %). Conclusions: There were high incidences of drug fever in all of the existing regimens.