الفهرس | Only 14 pages are availabe for public view |
Abstract Pediatric sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection and resulting organ damage that is associated with high morbidity and mortality. Bacteria are the most common cause of sepsis, and most patients with positive blood cultures harbor multidrug-resistant (MDR) gram-negative bacteria. β-lactams are the most frequently prescribed antibiotics for the treatment of pediatric sepsis worldwide due to their broad-spectrum activity and safety profile. Among the different mechanisms that can provide resistance to β-lactams in gram-negative bacteria, the production of various β-lactamases is the most important one. Additionally, the emergence and spread of MDR bacteria mostly due to the production of extended-spectrum β-lactamases (ESBL) and carbapenemases, is often responsible for antibiotic treatment failure and has been associated with higher mortality rates in pediatric intensive care unit (PICU) patients.The antibacterial activity of β-lactams is dependent on the duration of the maintenance of free concentration above the minimal inhibitory concentration (MIC) during each dosing interval. β-lactams have usually been administered by intermittent infusion (II), but this method of administration could result in concentrations below the MIC for the respective pathogen over a long period of the dosing interval. Prolonged infusion (PI) of β-lactams can maintain the duration of antibiotic concentration above MIC and improve antibacterial activity compared to II of β-lactams. |