Maria Ioannidou

Use of linezolid in pediatrics: a critical review.

BACKGROUND Linezolid, an oxazolidinone antibacterial agent, is available for intravenous/oral administration, with activity against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and penicillin-resistant Streptococcus pneumoniae (PRSP). These pathogens are important causes of hospital- and community-associated infections in children. METHODS PubMed was searched for all English language articles on patients younger than 18 years of age treated with linezolid, and an analysis of these articles was performed. RESULTS From the 133 articles retrieved, a total of 30 were studied (18 case reports, nine case series, and three clinical trials) based on the inclusion criteria preset for this review. In these articles, a total of 597 children received linezolid. MRSA was the most common pathogen, followed by VRE, PRSP, other bacteria and less common mycobacterial species. Linezolid was reported to be safe and effective for the treatment of pneumonia and endocarditis, as well as skin and soft tissue, central nervous system and osteoarticular infections. CONCLUSIONS Linezolid is promising as a safe and efficacious agent for the treatment of infections due to mainly resistant Gram-positive organisms in children who are unable to tolerate conventional agents or after treatment failure.

Outcome of urinary tract infections caused by extended spectrum β-lactamase-producing Enterobacteriaceae in children.

The outcome of patients with urinary tract infections caused by extended spectrum &bgr;-lactamases (ESBL)-producing bacteria (cases) was compared with that of matched controls with urinary tract infections caused by non-extended spectrum &bgr;-lactamases-producing isolates. Significantly, more case patients received inappropriate empiric therapy than controls. Nevertheless, clinical and microbiologic outcomes as well as formation of renal scars did not differ between the 2 groups.

Glomerular filtration rate is an independent factor of mortality in patients with decompensated cirrhosis

Although serum creatinine is included in the Model for End‐Stage Liver Disease (MELD) score, it is an inaccurate marker of renal function, namely, of glomerular filtration rate (“true” GFR) in patients with decompensated cirrhosis. Our aim was to investigate the impact of MELD score and “true” GFR as determinants of survival in patients with decompensated cirrhosis.

Comparison of creatinine and cystatin formulae with 51Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Evaluation of renal function, that is, glomerular filtration rate (GFR), has become very important, but conventional mathematical formulae for GFR assessment are inaccurate in patients with cirrhosis. The aim of the present study was to compare serum creatinine (sCr)‐based and serum cystatin C (cysC)‐based estimated GFR (eGFR) formulae with 51Chromium‐ethylenediaminetetraacetic acid GFR (51Chr‐GFR) in patients with stable decompensated cirrhosis.

Comparison of Creatinine and Cystatin Formulae with 51 Chromium-Edta Glomerular Filtration Rate in Patients With Decompensated Cirrhosis.

Evaluation of renal function, that is, glomerular filtration rate (GFR), has become very important, but conventional mathematical formulae for GFR assessment are inaccurate in patients with cirrhosis. The aim of the present study was to compare serum creatinine (sCr)‐based and serum cystatin C (cysC)‐based estimated GFR (eGFR) formulae with 51Chromium‐ethylenediaminetetraacetic acid GFR (51Chr‐GFR) in patients with stable decompensated cirrhosis.

Is There Still a Place for Conventional Amphotericin B in the Treatment of Neonatal Fungal Infections

Neonatal invasive fungal infections (IFIs) remain an increasing problem associated with high rates of morbidity and mortality, as well as late-onset neurodevelopmental implications. Invasive candidiasis remains the leading neonatal IFI. Candida albicans is the fungal species most often affecting this population, although a changing epidemiologic incidence to non-albicans Candida species is reported in some neonatal intensive care units. Many treatment recommendations are extrapolated from adult populations, emphasizing the need to establish the optimal antifungal agent, dosage, and duration of therapy in neonates. Historically, conventional amphotericin B has been considered an efficient and safe treatment approach for most neonatal IFIs. More recently, lipid formulations of amphotericin B have been studied, used alone or in combination with other antifungal agents such as azoles or echinocandins. The aim of this article is to review the published experience in the use of amphotericin B formulations to treat neonatal IFIs.