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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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The unique issues of outpatient parenteral antimicrobial therapy in children and adolescents

Mobeen H Rathore1

  • 1Division of Pediatric Infectious Diseases and Immunology, University of Florida College of Medicine, and Wolfson Children's Hospital, Jacksonville, Florida, USA. mobeen.rathore@jax.ufl.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 25, 2010
PubMed

Insights

Pediatric outpatient parenteral antimicrobial therapy (OPAT) requires different criteria than adult care due to unique challenges. Further research is needed to confirm its efficacy and safety in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Hospital Discharge Planning

Background:

  • Outpatient parenteral antimicrobial therapy (OPAT) decisions for pediatric patients differ significantly from adults.
  • Limited clinical studies and pharmacokinetic data exist for pediatric OPAT.
  • Children face unique challenges including specialized nursing needs, increased complication risks, and significant psychological impact from hospitalization.

Purpose of the Study:

  • To highlight the distinct considerations for pediatric OPAT compared to adult OPAT.
  • To identify gaps in current research regarding pediatric OPAT.
  • To underscore the need for further investigation into pediatric OPAT efficacy, safety, and cost-effectiveness.

Main Methods:

  • Review of existing literature on pediatric OPAT.
  • Analysis of challenges specific to pediatric antimicrobial therapy.
  • Comparison of pediatric and adult OPAT criteria.

Main Results:

  • Pediatric OPAT criteria diverge from adult protocols.
  • Pharmacokinetic data and clinical studies for pediatric OPAT are scarce.
  • Children are vulnerable to nosocomial infections, including those caused by multidrug-resistant organisms.

Conclusions:

  • Existing studies suggest pediatric OPAT is effective and safe.
  • Well-designed prospective trials are necessary to establish robust evidence.
  • Comprehensive cost-benefit analyses are required for optimal implementation of pediatric OPAT.

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