The hariet lane handbook of antimicrobial therapy , SÁCH TRA CỨU KHÁNG SINH HARIET LANE

SÁCH HARIET LANE LÀ QUỂN SÁCH KINH ĐIỂN TRONG GIỚI Y KHOA, SỬ DỤNG TRA CỨU KHÁNG SINH LIỀU DÙNG, ĐƯỜNG DÙNG, THẢI QUA GAN, QUA THẬN, QUA SỮA MẸ, HƯỚNG DẪN CHI TIẾT LỰA CHỌN KHÁNG SINH THEO TÁC NHÂN, THEO BỆNH CẢNH LÂM SÀNG, GIẢM LIỀU TRONG BỆNH NHÂN SUY THẬN, SUY GAN.

THE HARRIET LANE HANDBOOK OF PEDIATRIC ANTIMICROBIAL THERAPY

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THE HARRIET LANE HANDBOOK OF PEDIATRIC ANTIMICROBIAL THERAPY

Second Edition

Julia A McMillan, MD

Professor of Pediatrics Associate Dean for Graduate Medical Education Johns Hopkins University School of Medicine

Baltimore, Maryland

Carlton K K Lee, PharmD, MPH

Clinical Pharmacy Specialist, Pediatrics Program Director, Pediatric Pharmacy Residency

Department of Pharmacy The Johns Hopkins Hospital; Associate Professor, Pediatrics Johns Hopkins University School of Medicine

Baltimore, Maryland

George K Siberry, MD, MPH

Assistant Professor Department of Pediatrics Johns Hopkins University School of Medicine

Baltimore, Maryland

THE HARRIET LANE HANDBOOK OF PEDIATRIC

ANTIMICROBIAL THERAPY, SECOND EDITION

ISBN: 978-0-323-11247-5

Copyright © 2014 by Saunders, an imprint of Elsevier Inc.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein)

NOTICES

Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices,

or medical treatment may become necessary

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter

of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein

Previous edition copyrighted 2009

Library of Congress Cataloging-in-Publication Data

The Harriet Lane handbook of pediatric antimicrobial therapy / [edited by] Julia A McMillan … [et al.].—2nd ed

p ; cm

Handbook of pediatric antimicrobial therapy

Includes bibliographical references and index

Content Strategist: James Merritt

Content Development Specialist: Andrea Vosburgh

Publishing Services Manager: Pat Joiner

Design Manager: Steven Stave

Printed in the United States of America

Working together to grow libraries in developing countrieswww.elsevier.com | www.bookaid.org | www.sabre.org

We dedicate this second edition of

The Harriet Lane Handbook of Pediatric Antimicrobial Therapy to the clinicians

and investigators whose work has allowed continued improvement in our ability to treat and to prevent infections in infants

and children.

Karen C Carroll, MD

Director, Division of Medical Microbiology

Director, Medical Microbiology Fellowship Program

Professor of Pathology

Johns Hopkins University School of Medicine

Baltimore, Maryland

Lisa A Degnan, PharmD, BCPS

Clinical Assistant Professor

Ernst Mario School of Pharmacy

Rutgers, The State University of New Jersey;

Clinical Pharmacy Specialist, Pediatrics

Hackensack University Medical Center

Hackensack, New Jersey

Swathi Gowtham, MD

Clinical Fellow

Division of Pediatric Infectious Diseases

Division of Clinical Pharmacology

Johns Hopkins University School of Medicine

Baltimore, Maryland

Angela M Helder, PharmD, BCPS

Clinical Pharmacy Specialist

Pediatric Emergency Medicine

Division of Pediatric Infectious Diseases

Johns Hopkins University School of Medicine

Baltimore, Maryland

Carlton K K Lee, PharmD, MPH

Clinical Pharmacy Specialist, Pediatrics

Program Director, Pediatric Pharmacy Residency

Department of Pharmacy

The Johns Hopkins Hospital;

Associate Professor, Pediatrics

Johns Hopkins University School of Medicine

Baltimore, Maryland

vii

Melissa D Makii, PharmD, BCPS

Clinical Pharmacy Specialist

Kristine A Parbuoni, PharmD, BCPS

Clinical Pharmacy Specialist

Pediatric Critical Care

University of Maryland Medical Center

Pediatric Critical Care

Riley Hospital for Children at Indiana University Health Indianapolis, Indiana

Paul K Sue, MD

Clinical Fellow

Division of Pediatric Infectious Diseases

Johns Hopkins University School of Medicine Baltimore, Maryland

This second edition of The Harriet Lane Handbook of Pediatric

Antimicrobial Therapy was, like the first edition, a collaboration that

included the disciplines of pediatric infectious diseases, microbiology, and clinical pharmacology We recognize that decisions regarding effective antimicrobial therapy require the knowledge and experience

of all three of these disciplines, particularly when caring for children whose infections are complications of underlying conditions or

the compromised immunity that results from chemotherapy or

surgery.

For this edition, our microbiology expert was Dr Karen C Carroll, who kindly agreed to replace Dr James Dick, who is now retired

Dr Carroll reviewed and significantly revised Chapter 4, Mechanisms

of Action and Routes of Administration of Antimicrobial Agents,

and Chapter 5, Mechanisms of Drug Resistance The other faculty authors for the first edition have participated in this one, but the pediatric infectious diseases fellows, Drs Hiwot Hiruy, Swathi

Gowtham, and Paul K Sue, all contributed for the first time Their dedication to excellence in the care of their patients is reflected

in the care with which they have reviewed and revised Chapter 2, Recommended Empiric Antimicrobial Therapy for Selected Clinical Syndromes.

Because decision-making about antimicrobial selection and

dosage requires more than matching a “drug” to a “bug,” we are particularly proud to that Dr Carlton K K Lee was able to recruit former Pediatric Pharmacy residents Drs Lisa A Degnan, Angela

M Helder, Melissa D Makii, Elizabeth A Sinclair, and Kristine A Parbuoni to assist in revising Chapter 3, Drug Dosing in Special

Circumstances; Chapter 6, Therapeutic Drug Monitoring; Chapter 7, Adverse Drug Reactions; and Chapter 9, Antimicrobial Desensitization Protocols.

We have reviewed available evidence and current guidelines

from expert panels to provide recommendations that are as accurate and as contemporary as is possible We realize, however, that

new evidence and guidelines will emerge during the life of this

second edition, so we urge readers to consult additional resources, particularly for unusual infections or for suspected antimicrobial

resistance.

ix

Decisions regarding antimicrobial therapy for children require an understanding of biologic development, mechanisms of resistance, and pharmacology We hope that this handbook will help clinicians in their efforts to provide the most effective therapy for each individual

circumstance.

Karen C Carroll, MD Carlton K K Lee, PharmD, MPH

Julia A McMillan, MD George K Siberry, MD, MPH Swathi Gowtham, MD Hiwot Hiruy, MD Paul K Sue, MD Lisa A Degnan, PharmD, BCPS Angela M Helder, PharmD, BCPS Melissa D Makii, PharmD, BCPS Kristine A Parbuoni, PharmD, BCPS Elizabeth A Sinclair, PharmD, BCPS

Used in Tables

TABLE 1-1

*Some recommendations are for antibiotics that are not approved by the U.S Food and Drug Administration (FDA) for use in children, and some may not be approved for treatment of the pathogen listed

Recommendations are based on published evidence of efficacy.

A/C, Amoxicillin/clavulanic acid (Augmentin); AG, aminoglycoside; APCS, antipseudomonal cephalosporin; APPN, antipseudomonal

combination; BT, bioterrorism; CDC, Centers for Disease Control and Prevention; Ceph, cephalosporin; 1st Ceph, first generation cephalosporin; 2nd Ceph, second generation cephalosporin; 3rd Ceph, third

generation cephalosporin; CGD, chronic granulomatous disease;

CHL, chloramphenicol; CNS, central nervous system; CSF, cerebrospinal

producer; FQ, fluoroquinolone; GI, gastrointestinal; HUS, hemolytic uremic syndrome; IM, intramuscular; IV, intravenous; IVIg, intravenous immunoglobulin; LP, lumbar puncture; MIC, minimum inhibitory

concentration; NSAID, nonsteroidal anti-inflammatory drug; OCS, oral cephalosporin; OCS1, first generation oral cephalosporin; OCS2, second generation oral cephalosporin; OCS3, third generation oral cephalosporin; PCS, parenteral cephalosporin; PCS1, first generation parenteral

cephalosporin; PCS2, second generation parenteral cephalosporin; PCS3, third generation parenteral cephalosporin; PCS4, fourth

generation parenteral cephalosporin; PenG, penicillin G; Pen VK, penicillin

VK (oral); PID, pelvic inflammatory disease; Pip/tazo, piperacillin/

tazobactam (Zosyn); PO, by mouth; PPI, proton pump inhibitor; R/O, rule out; RE, reticuloendothelial; SS-Pen, semisynthetic penicillin (nafcillin, oxacillin); Tic/clav, ticarcillin/clavulanic acid (Timentin); TMP/SMX, trimethoprim/sulfamethoxazole; UTI, urinary tract infection; WBC, white

†Intramuscular streptomycin is usually recommended; if not available, kanamycin, amikacin, or capreomycin can be used.

for duration is provided Controlled trials are limited, and susceptibility testing may not correlate with clinical response Guidance from a specialist in treating mycobacterial infection is recommended.

benefits outweigh the risks.

ART, Antiretroviral therapy; DOT, directly observed therapy;

the appropriate formulation of amphotericin B should be made based

on a need to reduce toxicity associated with amphotericin B

deoxycholate Lipid complex and liposomal formulations are associated with fewer adverse events, but they do not enhance efficacy

Amphotericin B deoxycholate is the preferred formulation for treating neonates and other patients with renal involvement because lipid complex and liposomal forms do not achieve effective concentration

in the kidneys.

‡Candida albicans is generally susceptible to fluconazole; C krusei is resistant to fluconazole; C glabrata is often resistant to fluconazole but may be susceptible to high doses; C lusitaniae may be resistant to

amphotericin B.

Mortierella spp., Cunninghamella spp., Penicillium spp., Acremonium spp., and Fusarium spp.

404-639-2888 evenings and weekends).

(800-547-1392).

by Medical Center Pharmacy, New Haven, CT (203-688-6816), or by Panorama Compounding Pharmacy, 6744 Balboa Blvd., Van Nuys, CA

91406 (800-247-9767).

(41-1-211-24-32).

is not available in the United States.

pregnancy; safety during the second and third trimester has not been established It should not be used in patients with cardiac arrhythmias, bradycardia, severe cardiac disease, or prolonged QT interval, and it should not be given concomitantly with drugs that prolong the QT interval

or are metabolized by CYP2D6.

recommendations: 2010 update Perit Dial Int 2010;30:393-423.

A/C, Amoxicillin/clavulanic acid; AG, aminoglycoside; AP pen,

antipseudomonal penicillin; BAL, bronchoalveolar lavage; BL/BLI,

β-lactam plus β-lactamase inhibitor; CGD, chronic granulomatous disease; CMV, cytomegalovirus; CNS, central nervous system; CSF, cerebrospinal fluid; CT, computed tomography; EBV, Epstein-Barr virus; FDA, U.S Food and Drug Administration; FQ, fluoroquinolone; GAS, group A

streptococcus; GBS, group B streptococcus; GI, gastrointestinal;

GU, genitourinary; HSV, herpes simplex virus; IVIg, intravenous

immunoglobulin; MRSA, methicillin-resistant Staphylococcus

aureus; MRSE, methicillin-resistant Staphylococcus epidermidis;

MSSA, methicillin-susceptible Staphylococcus aureus;

NSAID, nonsteroidal anti-inflammatory drug; OCS2/3, second generation oral cephalosporin; OCS3, third generation oral cephalosporin; OM, otitis media; PCN, penicillin; PCR, polymerase chain reaction; PCS3, third generation parenteral cephalosporin; Pip/tazo, piperacillin/tazobactam; RFQ, respiratory fluoroquinolone (levofloxacin, moxifloxacin);

RSV, respiratory syncytial virus; STI, sexually transmitted

infection; TB, tuberculosis; Tic/clav, ticarcillin/clavulanic acid;

TMP/SMX, trimethoprim/sulfamethoxazole; UTI, urinary tract infection.

TABLE 3-1

*Pharmacogenomic polymorphisms should be taken under consideration for potential altered net effect.

↑, Increased; ↓, decreased; ?, unknown; BSA, body surface area; CNS, central nervous system; GI, gastrointestinal.

TABLE 3-3

*Route in parentheses indicates secondary route of excretion.

and assessment of renal insufficiency.

dose; for a GFR <5 mL/min, give 33% of full dose as first dose.

**If using high-flux hemodialysis (polysulfone polyamide and

polyacrylonitrile), give supplemental dose after dialysis.

?, Unknown; CrCl, creatinine clearance; D, dose reduction; DI, dose reduction and interval extension; D,I, dose reduction or interval extension;

He, hemodialysis; I, interval extension; N, no; N/A, not applicable; NRTI, nucleoside reverse transcriptase inhibitor; P, peritoneal dialysis;

Y, yes.

TABLE 3-4

CAVH, Continuous arteriovenous hemodialysis; CAVHD, continuous arteriovenous hemodialysis, CF, cystic fibrosis; CrCl, creatinine clearance

rate; CNS, central nervous system; CVVH, continuous venovenous hemofiltration; CVVHD, continuous venovenous hemodialysis;

IV, intravenous; PCP, Pneumocystis pneumonia; PO, by mouth.

TABLE 3-7

+, Use with caution in the presence of hepatic impairment;

IM, intramuscular; INR, international normalized ratio; IV, intravenous.

TABLE 3-8

ABW, Adjusted body weight (kg); ClCr, creatinine clearance

MIC, minimum inhibitory concentration; TBW, total or actual body weight (kg); Vd, volume of distribution (L/kg).

*Unique among β-lactams; binds to PBP2a, so it has methicillin-resistant

Staphylococcus aureus activity.

HBV, Hepatitis B virus; IM, intramuscular; INHAL, inhalation;

IV, intravenous; mRNA, messenger RNA; PBP, penicillin-binding protein; PO, by mouth; rRNA, ribosomal RNA; T, topical; tRNA, transfer

established Trough concentration at four to five times the minimum inhibitory concentration (MIC) has been recommended with higher concentrations; may be needed for sequestered infections or situations

of poor vancomycin tissue penetration.

age.

of saturation of voriconazole metabolism and higher than proportional

increase in exposure observed with an increasing dose; however, linear pharmacokinetics has been reported in younger children.

CNS, Central nervous system; IV, intravenous; MRSA, methicillin-resistant Staphylococcus aureus; N/A, not applicable; SSTI, skin and soft tissue

infection.

TABLE 6-2

*Reflects free-drug concentration measurements.

AUC/MIC, Area under the serum concentration versus time curve to

concentration to MIC ratio; T > MIC, duration of the dosing interval with serum concentrations exceeds the MIC; PD, pharmacodynamics;

AUC/MIC, Area under the serum concentration versus time curve

serum concentration to MIC ratio; PD, pharmacodynamics;

PK, pharmacokinetics.

TABLE 6-5

*Postantifungal effects have been identified for certain drugs

within the indicated antifungal drug class and specific Candida

strain.

AUC/MIC, Area under the serum concentration versus time curve to

concentration to MIC ratio; T > MIC, duration of the dosing interval with serum concentrations exceeds the MIC; PD, pharmacodynamics;

PK, pharmacokinetics.

TABLE 8-1

CDC, Centers for Disease Control and Prevention; CMV, cytomegalovirus; CSF, cerebrospinal fluid; DTaP, diphtheria and tetanus toxoids and acellular pertussis vaccine; Ig, immunoglobulin; IM, intramuscular;

IV, intravenous; IVIg, intravenous immunoglobulin; max, maximum;

Td, adult-type diphtheria and tetanus toxoids vaccine; Tdap, tetanus

toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine;

TMP/SMX, trimethoprim/sulfamethoxazole; TST, tuberculin skin test.

NA, Not applicable.

TABLE 9-10

Drink 180 mL water after each dose of trimethoprim/sulfamethoxazole (TMP/SMX) Subjects tolerating this protocol were prescribed 800/160 mg TMP/SMZ every Monday, Wednesday, and Friday for low-dose

Pneumocystis jiroveci (carinii) prophylaxis.

NA, Not applicable.

TABLE 9-11

*Administer doses as continuous 15-min infusions, except for the last three doses, which are given as 30-min infusions with no intervals between the doses.

TABLE 9-12

*Interval between doses is 15 min.

NA, Not applicable.

*Goal interval between doses is 20 minutes.

NA, Not applicable.

TABLE 9-19

*Interval between doses is 30 minutes.