Division of Pediatric Infectious Diseases and Immunology, University of Florida College of Medicine, and Wolfson Children's Hospital, Jacksonville, Florida, USA.
Clin Infect Dis. 2010 Sep 15;51 Suppl 2:S209-15. doi: 10.1086/653521.
The decision to discharge a hospitalized child or adolescent to receive outpatient parenteral antimicrobial therapy (OPAT) is based on criteria very different from those concerning adults. Clinical studies of pediatric OPAT are sparse, as are pharmacokinetic data for antimicrobial agents in children. Other issues unique to children are requirements for special nursing and intravenous infusion skills, as well as the increase of complications. The psychological disadvantage of hospitalization in children, compared with adults, is great, and both populations are equally vulnerable to nosocomial infection, increasingly augmented by multidrug-resistant organisms. Although the relatively few clinical studies involving OPAT in children attest to its efficacy and safety, well-designed prospective trials and comprehensive cost-benefit analyses are still needed.
决定将住院的儿童或青少年出院接受门诊肠外抗菌治疗 (OPAT) 的依据与成人完全不同。儿科 OPAT 的临床研究很少，儿童抗菌药物的药代动力学数据也很少。儿童特有的其他问题包括对特殊护理和静脉输注技能的要求，以及并发症的增加。与成人相比，儿童住院的心理劣势很大，这两个群体同样容易受到医院感染的影响，而耐多药生物体的增加使情况更加严重。尽管涉及儿童 OPAT 的少数临床研究证明了其疗效和安全性，但仍需要进行设计良好的前瞻性试验和全面的成本效益分析。
