Principles of curative antibiotic treatment

Infectious diseases are constantly evolving for many reasons. New infectious agents are regularly discovered, mainly because of the development of identification methods, including the molecular tools and mass spectrometry. Changes in the epidemiology of infectious diseases are not always understood, but several factors undoubtedly play an important role, notably the impact of vaccination implementations, the ecological consequences of antibiotic treatments and their excessive use, and the secular epidemiological trends of pathogenic agents. Antibiotic resistance has been recognized as one of the major challenges for humanity and few new antibiotics with potent activity against resistant Gram-negative rods have been developed in recent years. The rationalization of antibiotic treatments is a key for reducing or limiting antimicrobial resistance. This guide takes into account the latest recommendations, the consensus conferences, and the guidelines of the Pediatric Infectious Diseases Group of the French Society of Pediatric, the French Infectious Diseases Society, and French official agencies. For each clinical situation, the main bacterial target of the antibiotic treatment, the first-choice antibiotic and the alternative treatment, as well as the most important findings for the diagnosis and treatment of the infection are detailed.