Treatment option for sepsis in children in the era of antibiotic resistance

Expert Rev Anti Infect Ther. 2014 Oct;12(10):1237-52. doi: 10.1586/14787210.2014.956093. Epub 2014 Sep 4.


Sepsis caused by multidrug-resistant microorganisms is one of the most serious infectious diseases of childhood and poses significant challenges for pediatricians involved in management of critically ill children. This review discusses the use of pharmacokinetic/dynamic principles (i.e., prolonged infusion of β-lactams and vancomycin, once-daily administration of aminoglycosides and rationale of therapeutic drug monitoring) when prescribing antibiotics to critically ill patients. The potential of 'old' agents (i.e., colistin, fosfomycin) and newly approved antibiotics is critically reviewed. The pros and cons of combination antibacterial therapy are discussed and finally suggestions for the treatment of sepsis caused by multidrug-resistant organisms are provided.

Keywords: MDR gram-negatives; MDR gram-positives; PK/PD; TDM; antibiotic.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Drug Resistance, Bacterial*
  • Drug Synergism
  • Drug Therapy, Combination
  • Humans
  • Sepsis / drug therapy*
  • Sepsis / microbiology


  • Anti-Bacterial Agents