ACUTE BACTERIAL INFECTION IN KWASHIORKOR AND MARASMUS

About half the children admitted to this unit with severe malnutrition had an acute bacterial infection. Gram-negative infections of the urinary tract, or gut, and septicaemia were particularly troublesome, while Gram-positive infections gave less cause for concern. The cause of most of the chest infections remains unknown. Penicillin would have been appropriate for only a few infections, and if a routine antibiotic is thought to be necessary tetracycline would be better. There are, however, pertinent arguments against the routine use of antibiotics, and bacteriological evidence of infection should be sought wherever possible before the antibiotics are prescribed. If bacteriological services are not available antibiotics should be given only if there is clinical indication of a particular infection—for example, of the skin, chest, throat, gut or blood stream. © 1968, British Medical Journal Publishing Group. All rights reserved.