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- Title
Therapeutic Options and Outcomes for the Treatment of Children with Gram-Positive Bacteria with Resistances of Concern: A Systematic Review.
- Authors
Chiusaroli, Lorenzo; Liberati, Cecilia; Rulli, Luigi; Barbieri, Elisa; De Pieri, Marica; Di Chiara, Costanza; Mengato, Daniele; Giaquinto, Carlo; Donà, Daniele
- Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative Staphylococci (MR-CoNS), and vancomycin-resistant Enterococci (VRE) are increasing worldwide and represent a threat for the limited treatment options in pediatric patients and neonates compared to adults. Recommendations in pediatrics are mainly extrapolated from adults' studies. Methods: A literature search for the treatment of these pathogens in children (<18 years old) was conducted in Embase, MEDLINE, and Cochrane Library. Studies reporting data on single-patient-level outcomes related to a specific antibiotic treatment for multidrug resistant (MDR) Gram-positive bacterial infection in children were included. Studies reporting data from adults and children were included if single-pediatric-level information could be identified (PROSPERO registration: CRD42022383867). Results: The search identified 11,740 studies (since January 2000), of which 48 fulfilled both the inclusion and the exclusion criteria and were included in the analysis: 29 for MRSA, 20 for VRE, and seven for MR-CoNS. Most studies were retrospective studies. Vancomycin was mainly used as a comparator, while linezolid and daptomycin were the most studied antimicrobials showing good efficacy. Conclusions: Linezolid showed a safety and efficacy profile in a neonatal setting; daptomycin is increasingly used for MRSA, but the evidence is scarce for VRE.
- Subjects
GRAM-positive bacteria; GRAM-positive bacterial infections; METHICILLIN-resistant staphylococcus aureus; CHILD patients; ANTIBIOTICS; MICROCOCCACEAE; MULTIDRUG-resistant tuberculosis; KLEBSIELLA pneumoniae
- Publication
Antibiotics (2079-6382), 2023, Vol 12, Issue 2, p261
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics12020261