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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