Contemporary Treatment of Resistant Gram-Negative Infections in Pediatric Patients

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.