The use of piperacillin-tazobactam in neonatal and paediatric patients.
BACKGROUND
Piperacillin-tazobactam (PIP/TAZO) has been extensively used in adults with nosocomial infections and with fever and neutropenia. The available data considering the use of PIP/TAZO have not been reviewed in detail.


OBJECTIVE
Review discussing the use of PIP/TAZO in neonatal and paediatric patients.


METHODS
Medline search focusing on articles published in English. Owing to the paucity of randomized controlled trails, uncontrolled studies and case series were included.


CONCLUSIONS
PIP/TAZO may safely be used in paediatric patients as an empiric treatment for serious infections in hospital environments where resistance to common first-line antimicrobials has emerged. The most common indications in paediatric patients are nosocomial infections owing to resistant Gram-negatives, exacerbation of pulmonary colonization with Psuedomonas aeruginosa in patients with cystic fibrosis, intra-abdominal infections, fever and neutropenia in paediatric cancer patients. The influence of PIP/TAZO routine use on the selection of extended-spectrum beta-lactamase producing Gram-negatives and on the prevalence of vancomycin-resistant enterococci is still a matter of debate. In particular the use of PIP/TAZO in neonates and PIP/TAZO monotherapy in paediatric cancer patients with fever and neutropenia should be investigated in prospective randomized studies including a sufficient number of patients.
Wolf
Maria F
MF
University of Bonn, Children's Hospital, Medical Center, Department of Pediatric Hematology and Oncology, Adenauerallee 119, 53113 Bonn, Germany.
Simon
Arne
A
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination
D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin