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Updated: Dec 18, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Published on: August 30, 2018

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Optimizing Antibiotic Treatment Strategies for Neonates and Children: Does Implementing Extended or Prolonged

Paola Costenaro1, Chiara Minotti2, Elena Cuppini2

  • 1Division of Paediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, 35128 Padova, Italy.

Antibiotics (Basel, Switzerland)
|June 21, 2020
PubMed

Insights

Optimizing antibiotic dosing in children is crucial. Prolonged or continuous infusions may improve outcomes and reduce resistance compared to intermittent methods, though more pediatric research is needed.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacokinetics and Pharmacodynamics
  • Antimicrobial Stewardship

Background:

  • Optimizing antibiotic use in pediatrics is essential due to limited treatment options and the rising threat of antimicrobial resistance.
  • Dosing strategies, such as continuous or prolonged infusions, can enhance the efficacy of time-dependent antibiotics by maintaining concentrations above the minimum inhibitory concentration (MIC).

Purpose of the Study:

  • To review and assess the current evidence comparing intermittent versus prolonged intravenous antibiotic administration in pediatric and neonatal patients with bacterial infections.
  • To evaluate the state-of-the-art regarding antibiotic infusion strategies in optimizing treatment outcomes and managing antimicrobial resistance in children.

Main Methods:

  • A systematic literature search was conducted on PubMed for studies published between January 1, 2000, and April 15, 2020.
  • Included studies compared intermittent versus prolonged/continuous intravenous antibiotic infusions in the pediatric population, focusing on various antibiotics like vancomycin, piperacillin/tazobactam, ceftazidime, cefepime, and meropenem.

Main Results:

  • Nine relevant studies (RCTs, prospective, and retrospective) were selected for review.
  • Prolonged and continuous antibiotic infusions demonstrated a higher probability of achieving target pharmacokinetic/pharmacodynamic goals compared to intermittent infusions.
  • Generally favorable clinical outcomes and safety profiles were observed with prolonged/continuous infusion strategies.

Conclusions:

  • Prolonged and continuous antibiotic infusions show promise in pediatric bacterial infections, potentially improving target attainment and clinical outcomes.
  • Further research is needed to definitively establish the impact of these infusion strategies on efficacy, feasibility, and toxicity in children, as adult data may not be fully applicable.

Keywords:
antibioticchildrencontinuous infusionpediatrictime-dependent

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