The management of common infections in ambulatory children.
Antimicrobial therapy of infection in ambulatory children remains the cornerstone of the pediatrician's practice. Despite a cornucopia of newer antimicrobial agents, the older "tried and true" drugs continue to be favored based on their history of effectiveness, lack of toxicity, and low price. It also is clear that the widespread use of antimicrobial agents has contributed to the development of resistance. We must reevaluate our antimicrobial use so that we only treat infections likely to benefit from antimicrobials. Better diagnostic techniques should be developed for rapid and accurate identification of pathogens. Finally, alternative therapeutic strategies should be investigated, such as shorter courses of treatment or use of vaccines, to lessen the selective pressure on the microbial flora. To fail to meet this challenge will mean the more rapid transition into the "postantibiotic era".
Mason
W H
WH
University of Southern California School of Medicine, Division of Infectious Diseases, Children's Hospital, Los Angeles 90027, USA.
D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D004352:Drug Resistance, Microbial; D005759:Gastroenteritis / Q000188:drug therapy; D006801:Humans; D018942:Macrolides; D010033:Otitis Media / Q000188:drug therapy; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy; D012852:Sinusitis / Q000188:drug therapy; D014069:Tonsillitis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D018942:Macrolides; D010406:Penicillins