Treatment of Multidrug-Resistant Gram-Negative Infections in Children

Antibiotic resistance in conjunction with the erosion of the drug development pipeline may lead us into a bleak future, a "post-antibiotic era." Because of a shortage of studies addressing treatment options for multidrugresistant Gram-negative (MDRGN) infections in children, data must be e...

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Bibliographic Details
Published in:Clinical infectious diseases 2014-05, Vol.58 (10), p.1439-1448
Main Authors: Hsu, Alice J., Tamma, Pranita D.
Format: Article
Language:English
Subjects:
Acinetobacter baumannii - drug effects
Adult
Aminoglycosides
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Bacterial Proteins - metabolism
beta-Lactamases - metabolism
Biological and medical sciences
Carbapenems
Carbapenems - pharmacology
Carbapenems - therapeutic use
Child
Children & youth
Dosage
Drug Resistance, Multiple, Bacterial
Enterobacter
Enterobacteriaceae
Enterobacteriaceae - drug effects
Escherichia coli
Fluoroquinolones
Gram-negative bacteria
Gram-Negative Bacteria - drug effects
Gram-Negative Bacteria - enzymology
Gram-Negative Bacterial Infections - drug therapy
Gram-Negative Bacterial Infections - microbiology
Humans
Infections
Infectious diseases
Klebsiella pneumoniae
Medical sciences
Medical treatment
Microbial Sensitivity Tests
Multidrug resistant organisms
Pediatrics
Pseudomonas aeruginosa - drug effects
REVIEWS OF ANTI-INFECTIVE AGENTS
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Summary:Antibiotic resistance in conjunction with the erosion of the drug development pipeline may lead us into a bleak future, a "post-antibiotic era." Because of a shortage of studies addressing treatment options for multidrugresistant Gram-negative (MDRGN) infections in children, data must be extrapolated from the adult literature. However, even adult studies are limited by significant methodological flaws. We are in urgent need of pediatric specific pharmacokinetic/pharmacodynamic data for agents with activity against MDRGN infections as well as improved clinical outcomes studies. For the time being, we must rely on in vitro studies, observational data, and clinical experience to guide our therapeutic decisions. In this review, we discuss treatment considerations for infections caused by extended-spectrum β-lactamase–producing organisms, AmpC β-lactamase–producing organisms, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii in the pediatric population.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciu069