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Antibiotic Resistance Hits Pediatric Care

MANAGED CARE May 2014. © MediMedia USA
News & Commentary

Antibiotic Resistance Hits Pediatric Care

We reported last month on the seriousness of the problem of antibiotic-resistant bacteria (http://bit.ly/1hMgxTa). That problem affects all ages.

Most children (77%) are resistant to three or more antibiotics usually used for extended-spectrum beta-lactamose (ESBL)-producing enterobacteriaceae infections. This, according to a study in the Journal of the Pediatric Infectious Diseases Society.

Researchers conducted a case-case-control study of children ages 0 to 17 from 2008 to 2011, and note that the multidrug resistance presents a clinical care challenge.

“This drastically limits therapeutic options, particularly for oral drugs,” the study stated, adding that there are no clear-cut guidelines specifically aimed at children because “most antibiotic clinical trials for ESBL-producing infections are in adult populations.”

Most of the infections in the children (60%) are found in the ICU, though 30% occurred in outpatients.

“We found that the main risk factor for ESBL infection in children was having a neurologic comorbidity and that the majority of infections were multidrug-resistant,” the study stated. Other risk factors included chronic conditions, prior immunosuppressive therapy, and prolonged hospital stays.

“ESBL infections are increasing dramatically across the globe,” the study stated.

Latania K. Logan, MD, the study’s corresponding author, offered the opinion that health insurance plans should be concerned about this problem because “some infections in children that have typically been treated with oral antibiotics in the past may now require hospitalization and/or treatment with intravenous drugs as there may not be an oral option.”

Logan adds that one of the best ways insurers can help providers is by encouraging physicians “to obtain cultures for suspected bacterial infections so that laboratories can determine which antibiotics are best to treat infections.”

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HealthIMPACT Southeast Tampa, FL January 23, 2015