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The use of antibiotics in the treatment and prevention of infection in HIV‐infected children
Author(s) -
Ruga E,
Giaquinto C,
Cozzani S,
Giacomelli A,
Pagliaro A,
Mazza A,
Manzini A,
Laverda AM,
D'Elia R
Publication year - 1994
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb13339.x
Subject(s) - medicine , antibiotics , haemophilus influenzae , streptococcus pneumoniae , pneumocystis carinii , amoxicillin , pneumonia , clavulanic acid , malabsorption , ceftriaxone , trimethoprim , pharmacotherapy , immunology , intensive care medicine , microbiology and biotechnology , pneumocystis jirovecii , biology
Children with HIV infection have an unusual susceptibility to bacterial infection, related to several immune abnormalities. Selection of initial antibiotic therapy must be individualized in these children. Patients with community‐acquired disease are most likely to have infection by polysaccharide‐encapsulated bacterial organism, most commonly Streptococcus pneumoniae and less frequently by Haemophilus influenzae type b. If it is possible to treat the patients at home, the use of amoxicillin‐clavulanic acid might be appropriate. Other authors propose management with parenteral ceftriaxone because of the better compliance and the malabsorption. In hospitalized patients, concern for Gram‐negative enteric pathogens other than polysaccharide‐encapsulated organisms requires initial therapy with a third‐generation cephalosporine in combination with an aminoglycoside. Trimethoprim‐sulfamethizole is the most common drug used in HIV‐infected children because it is recommended for the initial therapy and for prophylaxis of Pneumocystis carinii pneumonia, which occurs in as many as 42% of these children.