Anti-infective treatment of gastro-intestinal tract infections in children.

Robert Cohen, Philippe Minodier, Isabelle Hau, Anne Filleron, Andreas Werner, Hervé Haas, Josette Raymond, Franck Thollot, Marc Bellaïche

Journal: Infectious diseases now 2023;53(8S):104784

PMID: 37739226

Full Text on Elsevier Science View on PubMed

Abstract

Gastroenteritis is most often viral in origin and Rotavirus and Norovirus most frequently implicated in young children. Stool-based multiplex Polymerase Chain Reaction (PCR) can detect bacteria, viruses or parasites that may or may not be responsible for gastroenteritis (colonization). While the etiological profile of these digestive infections has greatly benefited from PCR, in the absence of underlying pathologies the presence of potential pathogens does not justify anti-infectious treatment. Indeed, very few bacterial causes require antibiotic treatment, apart from shigellosis, severe forms of salmonellosis and a few Campylobacter sp. infections. The development of antibiotic resistance in Salmonella sp., Shigella sp. and Campylobacter sp. is a cause for concern worldwide, limiting therapeutic options. The antibiotics proposed in this guide are in line with the joint recommendations of the European Society of Pediatric Infectious Diseases and the European Society of Pediatric Gastroenterology and Nutrition. Azithromycin is preferentially used to treat infections with Shigella sp. or Campylobacter sp. Ceftriaxone and ciprofloxacin are recommended for salmonellosis requiring antibiotic therapy. Empirical treatments without bacterial identification are not indicated except in cases of severe sepsis or in subjects at risk (e.g., sickle-cell disease). Metronidazole should be prescribed only for acute intestinal amebiasis after microbiological confirmation.

Address: Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France; Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), Créteil, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France. Electronic address: [email protected].; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France; CHU de Marseille (Hôpital nord), Marseille, France.; Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France; Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil, France.; Department of Pediatrics, CHU de Nîmes, Univ. Montpellier, Nîmes, France.; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France.; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France; Neonatal Pediatrics Department Princess Grace Hospital, Monaco.; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie (GPIP), Créteil, France; Service de Microbiologie, Hôpital Kremlin Bicêtre, France.; Service de Gastro-entérologie Pédiatrique - Hôpital Robert-Debré - AP-HP, France.

DOI: 10.1016/j.idnow.2023.104784

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MeSH Terms: Humans, Child, Child, Preschool, Anti-Bacterial Agents, Gastroenteritis, Salmonella Infections, Campylobacter Infections, Communicable Diseases, Campylobacter, Bacteria