Efficacy and Safety of Sequential Treatment with Parenteral Sulbactam/Ampicillin and Oral Sultamicillin for Skeletal Infections in Children

“…The addition of sulbactam to ampicillin and clavulanate to amoxicillin provides a broad spectrum of activity, and these agents should be reserved in situations when first‐line, narrow‐spectrum agents cannot be used. High rates of efficacy between 93.3–100% have been demonstrated for ampicillin‐sulbactam (at dosages of 100–200 mg/kg/day q6h of the ampicillin component) and amoxicillin‐clavulanate (at 80 mg/kg/day of the amoxicillin component) in pediatric AHO (Table ) . Additionally, ampicillin‐sulbactam and amoxicillin‐clavulanate are both well tolerated.…”

Section: Treatment By Pathogenmentioning

confidence: 99%

“…Additionally, ampicillin‐sulbactam and amoxicillin‐clavulanate are both well tolerated. Diarrhea is the most common adverse effect, ranging from 0% to 33.3% (Table ) …”

Section: Treatment By Pathogenmentioning

confidence: 99%

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Management of Pediatric Acute Hematogenous Osteomyelitis, Part I: Antimicrobial Stewardship Approach and Review of Therapies for Methicillin‐Susceptible Staphylococcus aureus, Streptococcus pyogenes, and Kingella kingae

2018

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Acute hematogenous osteomyelitis (AHO), often occurring in young children, is the most frequently diagnosed type of osteomyelitis in pediatric patients. Optimizing antibiotics is essential as delays to receipt of appropriate therapy can lead to chronic osteomyelitis, as well as impairments in bone growth and development. Antimicrobial stewardship programs (ASPs) are in a key position to help improve the care of patients with AHO as they contain a pharmacist with expertise in antibiotic drug selection, optimization of dosing, and microbiologic test review. A literature search of the MEDLINE database was conducted from initiation through January 2018. Articles selected for the review focus on pathogen identification, pharmacokinetics and pharmacodynamics, efficacy and safety in children, transition from intravenous to oral therapy, duration of treatment, and antimicrobial stewardship interventions. This review will highlight the potential roles ASPs can have in improving the management of AHO in pediatric patients. These roles include the creation of clinical pathways, improving testing algorithms, antibiotic choice and dosing, intravenous to oral transitions, duration of treatment, and therapy monitoring. Overall, patients are most effectively treated by focusing treatments on age, presentation, local sensitivities, and directed therapy with pathogen identification.

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“…One more important advantage presented by sultamicillin is that even though most β lactamase-resistant antimicrobials must be given parenterally, sultamicillin is given by mouth. It has been found to be effective against skeletal infections in children, urinary infections in geriatric patients and uncomplicated gonorrhoea [48][49][50][51] .…”

Section: Synergistic Action With or Without Some Additional Benefitmentioning

confidence: 99%

Mutual prodrug concept: Fundamentals and applications

et al. 2006

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A therapeutically significant drug may have limited utilization in clinical practice because of poor organoleptic properties, poor bioavailability, short duration of action, nonspecificity, incomplete absorption, poor aqueous solubility, high first-pass metabolism or other adverse effects. There is a great emphasis on research to discover methods aimed at improving their therapeutic efficacy by minimizing or eliminating these undesirable properties. Sometimes, an adequate pharmaceutical formulation can overcome these drawbacks, but often the galenic formulation is inoperant and a chemical modification of active molecule is necessary to correct its pharmacokinetic insufficiencies. This chemical formulation process, whose objective is to convert an interesting active molecule into a clinically acceptable drug, often involves the so-called 'Prodrug design.' Mutual prodrug is a type of carrier-linked prodrug, where the carrier used is another biologically active drug instead of some inert molecule. A mutual prodrug consists of two pharmacologically active agents coupled together so that each acts as a promoiety for the other agent and vice versa. Mutual prodrug design is really no different from the general drug discovery process, in which a unique substance is observed to have desirable pharmacological effects, and studies of its properties lead to the design of better drugs. It is a very fruitful area of research, and its introduction in human therapy has given successful results in improving the clinical and therapeutic effectiveness of drugs suffering from some undesirable properties that otherwise hinder their clinical usefulness. The present article takes a review of various applications of mutual prodrugs and the developments in this field during the last few decades.

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Efficacy and Safety of Sequential Treatment with Parenteral Sulbactam/Ampicillin and Oral Sultamicillin for Skeletal Infections in Children

Cited by 14 publications

References 10 publications

Rational antibiotic therapy and the position of ampicillin/sulbactam

Rational antibiotic therapy and the position of ampicillin/sulbactam

Management of Pediatric Acute Hematogenous Osteomyelitis, Part I: Antimicrobial Stewardship Approach and Review of Therapies for Methicillin‐Susceptible Staphylococcus aureus, Streptococcus pyogenes, and Kingella kingae

Mutual prodrug concept: Fundamentals and applications

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