Management of Pneumonia in the Pediatric Critical Care Unit: An Area for Antimicrobial Stewardship

Title:Management of Pneumonia in the Pediatric Critical Care Unit: An Area for Antimicrobial Stewardship

Volume: 13 Issue: 1

Author(s): Aimee M. Dassner, David P. Nicolau and Jennifer E. Girotto

Affiliation:

Keywords: HAP, pediatric antimicrobial stewardship, pediatric pneumonia, pharmacodynamics, PICU, severe CAP, VAP.

Abstract: Background: Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator- associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit.

Objective: Respiratory infections, especially pneumonias, are a strong area for antimicrobial stewardship program (ASP) interventions, as they have been shown to improve patient outcomes while reducing inappropriate antimicrobial use, antimicrobial resistance, and overall costs.

Method: Optimizing the selection of appropriate antimicrobial therapies is difficult for pediatric pneumonias because of the ill-defined definitive diagnostic criteria and difficulty differentiating between viral and bacterial etiology.

Result: The aim of this review is to highlight the role of antimicrobial stewardship efforts in the treatment of pneumonias in critically ill children by discussing the emerging role of diagnostic criteria, the etiology of disease, appropriate targeted antimicrobial selection, and the optimization of antibiotic dosing and pharmacodynamic targets.

Cite this article as:

Dassner M. Aimee, Nicolau P. David and Girotto E. Jennifer, Management of Pneumonia in the Pediatric Critical Care Unit: An Area for Antimicrobial Stewardship, Current Pediatric Reviews 2017; 13 (1) . https://dx.doi.org/10.2174/1573396312666161205102221

DOI https://dx.doi.org/10.2174/1573396312666161205102221	Print ISSN 1573-3963
Publisher Name Bentham Science Publisher	Online ISSN 1875-6336