آيا مصرف آنتي بيوتيك از شدت تظاهرات باليني گلومر و لونفريت متعاقب استرپتوكوك مي كاهد؟

Does Anti6iotic Reduce the Severity of Post Streptococcal GLomerulbnephritis?

Abstract Background & Aim: Antibiotic treatment prevents new episode of Acute Post Streptococcal GlomeruloNephritis (APSGN). In this study we evaluated the correlation of antibiotic therapy and the severity of APSGN in children. Patients and Methods: Between 1989 and 2001, files of all patients with diagnosis of glomerulonephritis were reviewed retrospectively. Inclusion criteria were: 1- hematuria, 2- evidence of recent streptococcal infection(Rising ASO titer or positive culture) and 3-transient decrease of C3. According to the history of antibiotic usage for infection, the patients were divided in two groups. The severity of clinical and laboratory findings on admission were scored 0 to 4. T- student and Chi square were used for comparing means and frequency, respectively. P value less than 0.05 was considered significant. Results: Eighty six children with average age(SD) of 8.76(2.85) years were included in our study. The most frequent clinical presentations were as follows: hematuria(100%), edema and azotemia(70%), hypertension(68%), and proteinuria(53%). Meanwhile 53 cases had no history of antibiotic usage. The severity of edema(defined by more than 3 plus)(37.3% vs 18.2%), duration of hospitalization 11 vs 8.9 days) and maximum serum creatinine(2 vs 1.3 mg/dl) were significantly higher in that group which did not receive antibiotics(P<0.05). The mean of clinical, laboratory and total scores were statistically significant and higher in those without history of antibiotic(P<0.0001). Conclusion: Antibiotic prescription in prodromal phase may decrease the severity of acute post streptococcal presentation.