Treatment of multidrug-resistant gram-negative infections in children

Alice J. Hsu; Pranita D. Tamma

doi:10.1093/cid/ciu069

Treatment of multidrug-resistant gram-negative infections in children

Alice J. Hsu, Pranita D. Tamma

School of Medicine

Research output: Contribution to journal › Review article › peer-review

88 Scopus citations

Abstract

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 multidrug-resistant 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 Î-lactamase- producing organisms, AmpC Î-lactamase-producing organisms, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii in the pediatric population.

Original language	English (US)
Pages (from-to)	1439-1448
Number of pages	10
Journal	Clinical Infectious Diseases
Volume	58
Issue number	10
DOIs	https://doi.org/10.1093/cid/ciu069
State	Published - May 15 2014

Keywords

-lactamases
Acinetobacter baumannii
AmpC β;-lactamases
Carbapenemases
Extended-spectrum β
Pseudomonas aeruginosa

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1093/cid/ciu069

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note = "Funding Information: Potential conflicts of interest. P. D. T. receives salary support from a Pfizer Independent Grant for Learning and Change, unrelated to the current project. A. J. H. reports no potential conflicts. Funding Information: Financial support. This work was supported by a Thrasher Research Foundation award to P. D. T.",

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N2 - 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 multidrug-resistant 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 Î-lactamase- producing organisms, AmpC Î-lactamase-producing organisms, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii in the pediatric population.

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Treatment of multidrug-resistant gram-negative infections in children

Abstract

Keywords

ASJC Scopus subject areas

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