Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.

Determination of the etiology of bacterial meningitis and estimating cost of disease are important in guiding vaccination policies. To determine the incidence and etiology of meningitis in Turkey, cerebrospinal fl uid (CSF) samples were obtained prospectively from children (1 month-17 years of age) with a clinical diagnosis of acute bacterial meningitis. Multiplex PCR was used to detect DNA evidence of Streptococcus pneumoniae, Haemophilus infl uenzae type b (Hib), and Neisseria meningitidis. In total, 408 CSF samples were collected, and bacterial etiology was determined in 243 cases; N. meningitidis was detected in 56.5%, S. pneumoniae in 22.5%, and Hib in 20.5% of the PCR-positive samples. Among N. meningitidis-positive CSF samples, 42.7%, 31.1%, 2.2%, and 0.7% belonged to serogroups W-135, B, Y, and A, respectively. This study highlights the emergence of serogroup W-135 disease in Turkey and concludes that vaccines to prevent meningococcal disease in this region must provide reliable protection against this serogroup.

Hepatitis A is a worldwide vaccine-preventable infection. Recommendation of vaccination depends on the endemicity of the disease. The World Health Organization recommends universal hepatitis A vaccination in intermediate areas; however, there is no need of mass vaccination in high and low endemicity regions. Therefore, most of the countries are using a vaccination policy according to the endemicity characteristic representing the whole of the country. The endemicity of this infection varies due to sanitary and hygiene conditions and socioeconomic differences among the countries and in various regions of the same country. A sample of 1173 persons between the age of 0 and 91 years from nine randomly selected medical centres from five different geographical centres of Turkey were tested for the level of anti-hepatitis A virus (anti-HAV) immunoglobulin-G antibodies using an enzyme-linked immunosorbent assay. The overall prevalence of anti-HAV antibodies was 64.4% (1142/1173). While the rate of sero-positivity was over 80% in the 5-9 age group and more than 90% after 14 years of age in south-eastern and eastern regions, it was lower than 50% at the age of 5-9 years in central and western regions and remains under 80% in those areas. We conclude that the differences observed in HAV sero-positivity among various geographical regions in Turkey support a universal HAV immunization policy for children currently living in regions of intermediate endemicity.

The aim of this study is to investigate the effects of epilepsy, valproic acid and oxcarbazepine on nitric oxide levels, lipid peroxidation and xanthine oxidase levels in newly diagnosed epileptic children and healthy controls. A total of 49 patients with newly diagnosed idiopathic epilepsy and 15 healthy children were enrolled in this study. Of these 49 patients, 16 children were treated with valproate and 16 treated with oxcarbazepine. Nitric oxide, malondialdehyde and xanthine oxidase levels prior to antiepileptic drug therapy were measured in the serum. Blood samples were drawn before antiepileptic drug therapy and after 3 and 6 months of the antiepileptic drug treatment. Nitric oxide levels were statistically higher in the newly diagnosed epileptic patients. In oxcarbazepine group, the nitric oxide and malondialdehyde levels were found to be decreased. No statistically significant differences were noted in nitric oxide, malondialdehyde and xanthine oxidase levels in valproic acid treated group. Oxcarbazepine which is a frequently used new antiepileptic drug in childhood epilepsy may modify nitric oxide levels and lipid peroxidation. These results suggest that decreased lipid peroxidation would play a role in the mechanism of antiepileptic effects by oxcarbazepine treatment.

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