August 22, 2023

Before You Choose Antibiotics for a Child or Adolescent

12 minutes

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

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