Contemporary issues in the management of pediatric infections.
BACKGROUND
Pediatric infections still pose numerous challenges, and expert guidance is needed on many current issues including diagnostic methods and the optimal choice and duration of therapy.


OBJECTIVE
To highlight areas of current concern and controversy and to provide some pointers to factors affecting the choice of antibiotic therapy.


CONCLUSIONS
Most community-acquired pediatric infections are diagnosed on clinical grounds. Treatment is initiated on an empiric basis; microbiologic diagnosis is usual only for urinary tract infections and tonsillitis. The choice of the most appropriate antibiotic agent for ambulatory treatment depends on antimicrobial activity and pharmacokinetic parameters as well as on compliance-enhancing features such as once daily dosing, good tolerability and the acceptability of the pediatric formulation. The newer oral cephalosporins such as ceftibuten have a favorable combination of properties including excellent clinical efficacy and are increasingly being used in preference to penicillins. Although clinical cure is regarded as the "gold standard" in the evaluation of therapy, the importance of bacterial eradication must also be emphasized.
Helwig
H
H
Children's Hospital St. Hedwig, Freiburg, Germany.
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy*; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008826:Microbial Sensitivity Tests; D010349:Patient Compliance; D010406:Penicillins / Q000627:therapeutic use; D014069:Tonsillitis / Q000175:diagnosis / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins