Antibiotic Resistance in Pediatric Infections: Global Emerging Threats, Predicting the Near Future

Abstract

Antibiotic resistance is a public health threat of the utmost importance, especially when it comes to children: according to WHO data, infections caused by multidrug resistant bacteria produce 700,000 deaths across all ages, of which around 200,000 are newborns. This surging issue has multipronged roots that are specific to the pediatric age. For instance, the problematic overuse and misuse of antibiotics (for wrong diagnoses and indications, or at wrong dosage) is also fueled by the lack of pediatric-specific data and trials. The ever-evolving nature of this age group also poses another issue: the partly age-dependent changes of a developing system of cytochromes determine a rather diverse population in terms of biochemical characteristics and pharmacokinetics profiles, hard to easily codify in an age- or weight-dependent dosage. The pediatric population is also penalized by the contraindications of tetracyclines and fluoroquinolones, and by congenital malformations which often require repeated hospitalizations and pharmacological and surgical treatments from a very young age. Emerging threats for the pediatric age are MRSA, VRSA, ESBL-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae and the alarming colistin resistance. Urgent actions need to be taken in order to step back from a now likely post-antibiotic era, where simple infections might cause infant death once again.

Naturopathic patient care during different life stages: an international observational study of naturopathic practitioners and their patients

“…For example, steroid treatments are commonly prescribed as a first line of treatment for inflammatory skin conditions and asthma [ 36 , 37 ], and some parents hold concerns regarding the safety of steroid medications in children despite their documented effectiveness [ 38 ]. Similarly, published adverse events of other medications such as increased risk of suicide associated with the acne medication isotretinoin [ 39 ] as well as global concerns with over-prescription of antibiotics [ 40 ] may ‘push’ patients and their parents to seek other treatment options for conditions such as acne and respiratory infections [ 41 ]. In contrast, naturopathic care for these conditions embrace principles of complexity and holism [ 12 , 13 ] by treating related physiological systems that may directly and indirectly impact on the presentation of a skin or respiratory condition such as the gastrointestinal system as was identified in our study and is described in naturopathic clinical texts and other practice-based research [ 16 , 22 ].…”

Perteklinė Medicina Pediatrijoje

“…Dėl to nukenčia ir sveikatos apsaugos sistema, kadangi jos ištekliai nėra naudojami efektyviai. Atliekama vis daugiau studijų, tiriančių neracionalų medikamentinį gydymą bei diagnostinių testų skyrimą vaikams [1][2][3]. Dažniausiai tai objektyviai nepagrįstas antibiotikų skyrimas, tų pačių diagnostinių testų kartojimas ar nepakankamas nuskausminimas.…”

Antibiotic Resistance. Scale and Relevance of Studies of the Antibiotic-Resistant Isolates Circulation among Children

“…Нераціональний вибір препарату або його доз, відсутність моніторингу концентрацій антибіотика в крові, недостатнє знання патогенних мікроорганізмів, пов'язаних з інфекціями, нерозуміння фармакокінетичних та фармакодинамічних характеристик конкретних класів антибіотиків в педіатричній популяції -це все проблеми призначення протимікробних засобів дітям [21,24]. Дані явища призводять до того, що мети лікування не досягається, а під селективним тиском використовуваних антибіотиків залишаються стійкі мікроорганізми, які в подальшому, відповідно, призводять до стійких інфекцій.…”