Antibiotic selection can be complicated. In this episode, we discuss how you should approach choosing the appropriate antibiotic for your pediatric patient. There are multiple considerations, including: What organisms do you want to treat? What does anatomy have to do with antibiotic selection? You also have to think about individual circumstances, such as immunzation status, chronic disease, drug allergies, and environmental exposures.

• Know what organisms you want to treat
  • Because we often treat empirically, we need to know organisms that typically case this typical infection
  • Narrow-spectrum antibiotics if possible
• Anatomy of the infection
  • For fever in first 4-6 weeks, think about organisms that infant was exposed to during pregnancy and delivery
  • For respiratory infections, think about organisms that live in the respiratory tract
  • Abnormal anatomy
• Immunization status of child may change your differential diagnosis
• Drug allergies
  • Look in medical record and ask patient and family about allergies
  • Consider cross-reactivity of antibiotics
• Geographic location: resistance patterns
• Individual circumstances
  • Chronic diseases
  • Environmental exposures

Resources/Links:

Up to date: uptodate.com  

American Academy of Pediatrics Red Book: https://publications.aap.org/redbook?autologincheck=redirected 

Sanford Guide to Antimicrobial therapy: https://www.sanfordguide.com/products/print-guides/?gad=1&gclid=CjwKCAjwtuOlBhBREiwA7agf1oWtsyBrx0OFaHxpG2ZpDTXYukd1JGs5R_ZpRWrECT_v0bqhboN15hoCijIQAvD_BwE

American Academy of Pediatrics clinical practice guideline: The Diagnosis and Management of Acute Otitis Media. 2013. https://publications.aap.org/pediatrics/article/131/3/e964/30912/The-Diagnosis-and-Management-of-Acute-Otitis-Media

Links:

https://publications.aap.org/redbook?autologincheck=redirected

About the Speaker:

Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA.

Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.