Related Experiment Videos
New trends in paediatric antibiotic therapy
1Paediatric Department IV, Sacco Hospital, Milan, Italy.
Insights
New antibiotics offer limited advantages in pediatric care, with few exceptions like specific cephalosporins, aztreonam, and novel macrolides, which provide significant therapeutic improvements for certain infections.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Many new antibiotics for pediatric use lack advantages over older drugs and are expensive.
- Few novel antibiotics offer significant improvements in pediatric antibiotic therapy.
Purpose of the Study:
- To evaluate the therapeutic benefits of newly marketed antibiotics in pediatric patients.
- To identify specific antibiotics with unique characteristics for improved pediatric treatment.
Main Methods:
- Review of recently marketed antibiotics for pediatric use.
- Comparative analysis of efficacy, safety, and cost-effectiveness against older drugs.
- Focus on third-generation cephalosporins, aztreonam, and new macrolides.
Main Results:
- Ceftazidime and cefsulodin show high activity against Pseudomonas spp., aiding life-threatening infections.
- Aztreonam, a monobactam, targets aerobic Gram-negative bacilli with a safer profile than aminoglycosides.
- New macrolides are effective against erythromycin-resistant bacteria and have fewer side effects and drug interactions.
Conclusions:
- Specific new antibiotics like ceftazidime, cefsulodin, aztreonam, and new macrolides offer distinct advantages in pediatric care.
- Aztreonam presents a safer alternative for Gram-negative infections in children.
- New macrolides enhance compliance and efficacy, particularly for resistant Gram-positive strains.
Abstract:
Recently many new antibiotics have been marketed for use in paediatrics. Most of them offer no real advantage in comparison to older drugs and their prescription is questionable, particularly because they are highly expensive. Only a few have a number of special characteristics which permit in certain patients a significant improvement of antibiotic therapy. Among these there are some third-generation cephalosporins such as ceftazidime and cefsulodin, aztreonam and the new macrolides. Ceftazidime and cefsulodin are highly active, particularly against Pseudomonas spp., thus offering new therapeutic possibilities in life-threatening infections due to these bacteria. Aztreonam is the first monobactam and has a spectrum of activity limited to the aerobic Gram-negative bacilli. Its indications are therefore very similar to those of the aminoglycosides but its use seems to be safer because it has none of the important side-effects of those drugs. Alone or in combination, it may become the drug of choice to treat children with infection due to Gram-negative bacteria. New macrolides are active against erythromycin-resistant bacteria, have a lower risk of gastrointestinal side-effects and have no interference with concomitant administered drugs such as theophylline. Therefore they may be used with higher compliance and better efficacy, especially in the areas where erythromycin-resistant Gram-positive strains are increasingly evident.