Department of Antimicrobial Stewardship, University of Mississippi Medical Center, Jackson, Mississippi.
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Infect Dis. 2022 Oct 1;35(5):442-451. doi: 10.1097/QCO.0000000000000857. Epub 2022 Jul 15.
Community-acquired pneumonia (CAP) and urinary tract infections (UTI) are two common childhood infections often leading to hospital admission. National guidelines for CAP and UTI in children recommend durations of antibiotic therapy of 10 days and 7-14 days, respectively. Due to concerns of rising antimicrobial resistance and an increased awareness of harms associated with prolonged courses of antibiotics, there is a renewed emphasis on reevaluating commonly prescribed durations of antibiotic therapy across bacterial infections. We describe recent clinical trials and observational studies evaluating durations of therapy for CAP and UTI in adults and children and translate the findings to our suggested approach for selecting durations of antibiotic therapy in hospitalized children.
There is a growing body of evidence, primarily in adults, that shorter durations of therapy than are commonly prescribed are just as effective as longer durations for CAP and UTIs.
Combining clinical trial data from adults with available data in children, we believe it is reasonable to consider 5 days of therapy for CAP, 3-5 days of therapy for cystitis, and 7 days of therapy for pyelonephritis for most hospitalized children with uncomplicated infections.
社区获得性肺炎（CAP）和尿路感染（UTI）是两种常见的儿童感染，常导致住院治疗。针对儿童 CAP 和 UTI 的国家指南建议抗生素治疗的持续时间分别为 10 天和 7-14 天。由于对抗菌药物耐药性上升的担忧以及对延长抗生素疗程相关危害的认识提高，人们重新强调对常见细菌感染的抗生素治疗持续时间进行评估。我们描述了最近评估成人和儿童 CAP 和 UTI 治疗持续时间的临床试验和观察性研究，并将这些发现转化为我们建议的选择住院儿童抗生素治疗持续时间的方法。
越来越多的证据主要来自成人，表明与较长疗程相比，较短疗程的治疗对于 CAP 和 UTI 同样有效。
将成人临床试验数据与儿童可用数据相结合，我们认为对于大多数患有单纯感染的住院儿童，CAP 可考虑 5 天疗程，膀胱炎 3-5 天疗程，肾盂肾炎 7 天疗程。
