Pediatrics. 1997 Feb;99(2):289-99.
This statement provides guidelines for therapy of children with serious infections possibly caused by Streptococcus pneumoniae. Resistance of invasive pneumococcal strains to penicillin, cefotaxime, and ceftriaxone has increased over the past few years. Reports of failures of cefotaxime or ceftriaxone in the treatment of children with meningitis caused by resistant S pneumoniae necessitates a revision of Academy recommendations. For nonmeningeal infections, modifications of the initial therapy need to be considered only for patients who are critically ill and those who have a severe underlying or potentially immunocompromising condition or patients from whom a highly resistant strain is isolated. Because vancomycin is the only antibiotic to which all S pneumoniae strains are susceptible, its use should be restricted to minimize the emergence of vancomycin-resistant organisms. Patients with probable aseptic (viral) meningitis should not be treated with vancomycin. These recommendations are subject to change as new information becomes available.
本声明为可能由肺炎链球菌引起的严重感染儿童的治疗提供指导原则。在过去几年中，侵袭性肺炎球菌菌株对青霉素、头孢噻肟和头孢曲松的耐药性有所增加。有报告称，头孢噻肟或头孢曲松治疗由耐药性肺炎链球菌引起的儿童脑膜炎失败，因此有必要修订学会的建议。对于非脑膜感染，仅对重症患者、有严重基础疾病或潜在免疫功能低下状况的患者或分离出高耐药菌株的患者，才需要考虑对初始治疗进行调整。由于万古霉素是所有肺炎链球菌菌株均敏感的唯一抗生素，应限制其使用以尽量减少耐万古霉素微生物的出现。可能患有无菌性（病毒性）脑膜炎的患者不应使用万古霉素治疗。随着新信息的出现，这些建议可能会有所变化。
