Contemporary Treatment of Resistant Gram-Negative Infections in Pediatric Patients

Samantha A Basco; Jennifer E Girotto

doi:10.1016/j.idc.2021.11.007

Contemporary Treatment of Resistant Gram-Negative Infections in Pediatric Patients

Infect Dis Clin North Am. 2022 Mar;36(1):147-171. doi: 10.1016/j.idc.2021.11.007.

Authors

Samantha A Basco¹, Jennifer E Girotto²

Affiliations

¹ University of Connecticut, Storrs CT and Connecticut Children's, Hartford, CT, USA.
² University of Connecticut School of Pharmacy, Connecticut Children's, Hartford, CT, USA. Electronic address: Jgirotto@connecticutchildrens.org.

PMID: 35168707
DOI: 10.1016/j.idc.2021.11.007

Abstract

Gram-negative resistance is increasing in serious infections, including in children. There are many mechanisms of resistance, most commonly beta-lactamases. The most concerning beta-lactamases are AmpC, extended spectrum beta-lactamases, and carbapenemases. Efflux pumps and porins are also important in Pseudomonas infections. For some mechanisms of resistance, dose adjustment of antibiotics may help to overcome resistance and effectively treat infections. Therefore, it is important to consider pediatric pharmacokinetic differences when dosing antibiotics to ensure adequate concentrations are reached and maintained. These considerations important for older antibiotics and newer agents.

Keywords: Antimicrobial stewardship; Pharmacotherapy; Resistance.

Publication types

Review

MeSH terms

Anti-Bacterial Agents* / pharmacology
Anti-Bacterial Agents* / therapeutic use
Child
Humans
beta-Lactamases*

Substances

Anti-Bacterial Agents
beta-Lactamases