Antibiotic restriction programs and cephalosporin use in pediatrics: a survey of infectious disease specialists

A survey of 105 pediatric infectious disease specialists was conducted to elicit opinions regarding antibiotic restriction programs and use of individual parenteral cephalosporins in pediatrics. Virtually all respondents favored antibiotic restriction programs, with 68% currently involved in these efforts. Unrestricted availability of cefazolin, cephalothin, cefoxitin, and cefuroxime was recommended by 83%, 72%, 58%, and 49%, respectively, of respondents. Restricted use of third-generation cephalosporins, including cefotaxime, cefoperazone, ceftizoxime, and moxalactam was generally recommended. Over 50% of respondents recommended the use of chloramphenicol plus ampicillin (or a penicillinase-resistant penicillin), while 21.9% advocated the use of cefuroxime as empiric therapy to treat the increasing number of H. influenzae species resistant to ampicillin in infants outside the neonatal period and in young children.