Treatment of Multidrug-Resistant Gram-Negative Infections in Children

被引：116
作者：
Hsu, Alice J. [1 ]
Tamma, Pranita D. [2 ]
机构：
[1] Johns Hopkins Univ Hosp, Div Pediat Pharm, Dept Pharm, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Infect Dis, Baltimore, MD 21287 USA
来源：
CLINICAL INFECTIOUS DISEASES | 2014年 / 58卷 / 10期
关键词：
extended-spectrum beta-lactamases; carbapenemases; AmpC beta-lactamases; Acinetobacter baumannii; Pseudomonas aeruginosa; VENTILATOR-ASSOCIATED PNEUMONIA; CRITICALLY-ILL PATIENTS; AMPC BETA-LACTAMASE; BROAD-SPECTRUM CEPHALOSPORINS; KLEBSIELLA-PNEUMONIAE; URINARY-TRACT; ACINETOBACTER-BAUMANNII; INTRAVENOUS COLISTIN; ESCHERICHIA-COLI; PIPERACILLIN-TAZOBACTAM;
D O I：
10.1093/cid/ciu069
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
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 beta-lactamase-producing organisms, AmpC beta-lactamase-producing organisms, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii in the pediatric population.
引用
收藏
页码：1439 / 1448
页数：10
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