Lockowitz Christine R, Hsu Alice J, Chiotos Kathleen, Bio Laura L, Dassner Aimee M, Gainey Andrew B, Girotto Jennifer E, Iacono Denise, Morrisette Taylor, Stimes Grant, Tran M Tuan, Wilson William S, Tamma Pranita D
Department of Pharmacy, St. Louis Children's Hospital, St. Louis, MO, United States.
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
J Pediatric Infect Dis Soc. 2025 Feb 6;14(2). doi: 10.1093/jpids/piaf004.
The Infectious Diseases Society of America (IDSA) publishes annual guidance on the treatment of antimicrobial-resistant (AMR) gram-negative infections. Within the AMR guidance, suggested dosages of antibiotics for adults infected with AMR pathogens are provided. This document serves as a companion document to the IDSA guidance to assist pediatric specialists with dosing β-lactam agents for the treatment of AMR infections in children. A panel of 13 pediatric infectious diseases specialists, including 11 pharmacists and 2 physicians, reviewed existing pharmacokinetic/pharmacodynamic, animal, and clinical data for newer β-lactam agents that are available in the United States and suggested for the treatment of AMR infections (ie, cefiderocol, ceftazidime-avibactam, ceftazidime-avibactam and aztreonam, ceftolozane-tazobactam, imipenem-cilastatin-relebactam, meropenem-vaborbactam, sulbactam-durlobactam). Suggested dosing for ampicillin-sulbactam is also provided, given complexities in dosing for carbapenem-resistant Acinetobacter baumannii infections. Consensus-based suggested dosing for β-lactam agents used to treat AMR infections in neonates, infants, children, and adolescents and relevant supporting evidence are provided. Content is up to date as of December 1, 2024. Gaps and limitations to existing data are discussed. Optimizing antibiotic dosing is critical to improving the outcomes of children with AMR infections.
美国传染病学会（IDSA）发布了关于抗微生物药物耐药（AMR）革兰氏阴性菌感染治疗的年度指南。在AMR指南中，给出了感染AMR病原体的成人抗生素建议剂量。本文档作为IDSA指南的配套文件，以协助儿科专家确定用于治疗儿童AMR感染的β-内酰胺类药物剂量。一个由13名儿科传染病专家组成的小组，包括11名药剂师和2名医生，回顾了美国现有的新型β-内酰胺类药物的药代动力学/药效学、动物和临床数据，这些药物被推荐用于治疗AMR感染（即头孢地尔、头孢他啶-阿维巴坦、头孢他啶-阿维巴坦和氨曲南、头孢洛扎-他唑巴坦、亚胺培南-西司他丁-瑞巴坦、美罗培南-法硼巴坦、舒巴坦-杜洛巴坦）。鉴于耐碳青霉烯鲍曼不动杆菌感染的给药复杂性，还给出了氨苄西林-舒巴坦的建议剂量。提供了用于治疗新生儿、婴儿、儿童和青少年AMR感染的β-内酰胺类药物基于共识的建议剂量及相关支持证据。内容截至2024年12月1日是最新的。讨论了现有数据的差距和局限性。优化抗生素剂量对于改善AMR感染儿童的治疗结果至关重要。
