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Current concepts in antibiotic resistance.

Thomas M Andrews1

  • 1Department of Otolaryngology, University of South Florida All Children's Hospital, St. Petersburg, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|November 25, 2003
PubMed
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Pediatric patients, especially young children with daycare exposure and recent antibiotic use, face increasing antibiotic resistance. High-dose or broad-spectrum antibiotics may be needed for resistant infections, necessitating local resistance surveillance.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Microbiology

Background:

  • Antibiotic resistance poses a growing challenge in pediatric surgical subspecialties.
  • Patients often present after prolonged medical therapy, making antibiotic resistance a critical management factor.
  • Increasingly, organisms exhibit multi-drug resistance, impacting clinical practice.

Purpose of the Study:

  • To review the scope of antibiotic resistance in pediatric otolaryngology.
  • To discuss mechanisms of resistance and pharmacodynamics.
  • To examine selected infections and their resistance patterns.

Main Methods:

  • Literature review focusing on antibiotic resistance in pediatric otolaryngology.
  • Analysis of risk factors for infections with resistant organisms.

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  • Discussion of treatment implications and surveillance strategies.

    • Main Results:

    • Children aged 2 years or younger with daycare exposure and recent antibiotic treatment are at higher risk.
    • While resistance to common outpatient antibiotics is increasing, first-line therapies remain effective for many infections.
    • Pneumococcal vaccines reduce severe infections, but outpatient otolaryngologic infections have seen only a slight decline.

    Conclusions:

    • Consider high-dose or broad-spectrum antibiotics for at-risk pediatric patients (young, daycare attendees, recent antibiotic use).
    • Suspect multi-drug resistant strains in children with treatment-refractory infections.
    • Continuous surveillance of local and regional antimicrobial resistance patterns is crucial for effective management.