Notable Changes to 2017 Nelson’s Pediatric Antimicrobial Therapy, 23rd Editio
Antifungals
Isavuconazole US Food and Drug Administration (FDA) approval and dosing in ad
provided
New Infectious Diseases Society of America (IDSA) guidelines for candidiasis
incorporated
New IDSA guidelines for aspergillosis incorporated
Parasites
Mebendazole included again after it was not available at the time the 2016 edition
published
The emphasis on use of miltefosine (available from the Centers for Disease Control
Prevention) for the treatment of free-living amoebae
HIV
Updated HIV treatment and postexposure prophylaxis recommendations
Ceftaroline
New FDA-approved option for intravenous (IV) therapy for invasive methicillin-­
resistant Staphylococcus aureus (MRSA) infections in children down to 3 months of
age: ceftaroline is a fifth-generation cephalosporin (with excellent activity against
S ­aureus and most other gram-positive pathogens, including MRSA, as well as ­
methicillin-resistant coagulase-negative S aureus). We now have another option ­
beyond vancomycin and clindamycin. Best studied in complicated skin infections
and pneumonia.
Ceftazidime/Avibactam
New IV therapy option for children with meropenem/imipenem-resistant gram-
negative bacilli (eg, Escherichia coli, Klebsiella) that is approved for adults and under
study in children: ceftazidime/avibactam. It is available in most hospital pharmacies
for patients with resistant organisms. Our use will be mostly in children with urolog
anomalies and recurrent urinary tract infection.
Pneumonia
The Pediatric Infectious Diseases Society/IDSA community-acquired pneumonia
(CAP) guidelines from 2011 recommending plain old ampicillin IV for empiric
therapy in immunized children has held up to post-implementation review in new
publications—a big score for decreasing unnecessary routine exposure of children to
ceftriaxone. Amoxicillin can be used for CAP if hospitalization is not required.
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