Introduction
Antimicrobial treatment has become common due to the success it has in treating bacterial and fungal diseases. However, there have been cases where the body has developed resistance to certain antimicrobial treatments, which has rendered them ineffective. A review of the current literature on the topic will provide important insight. The literature review will cover the uses of antimicrobial treatment in children, potential long-term effects, and methods to mitigate the effects.
Literature Review
Infectious diseases significantly affect children and contribute to high hospitalization rates in pediatric wards. Antibiotics are the most common treatment method for infectious diseases, and they are used at a rate of 37% in pediatric inpatient settings (Lee et al., 2018). The authors used a qualitative type of research, which was a review of current and relevant literature.
Lee et al. (2018) study showed that clinicians had to prescribe antibiotics based on vitro activity and clinical efficacy. According to Lee et al. (2018), the use of antibiotics has helped drastically reduce the mortality rate of pneumonia in children. The study suggested that antibiotic treatment should not be used for mild cases of pneumonia infection as it can cause resistance and that clinicians should analyze the potential side effects before prescribing antibiotics to patients. This also indicates that certain antimicrobial treatments have a higher risk of enhancing resistance in children.
Various studies have shown that children are at a higher risk of developing resistance as they are highly prone to infectious diseases. Therefore, the application of antibiotics and antimicrobial treatments has helped eliminate the mortalities of children for certain infectious diseases.
The article from Qiu et al. is a review of the literature on antibiotics, their historical formation and development, and their effectiveness. High incidence rates for diseases such as respiratory infections, diarrheal diseases, parasitic and invasive bacterial infections, and chronic conditions contribute to a rise in the use of antimicrobial treatments (Qiu et al., 2020). These agents can be applied solely or through a combination with other therapies.
Qiu et al. (2020) investigated the different antimicrobial agents that can be applied to treat dental caries or tooth decay, which is a common oral disease. The study highlighted the potential of antibiotics such as penicillin, macrolides, and clindamycin in the treatment of several bacterial infections. Guidelines for how to administer antibiotics have helped in eliminating risks that were present in the past.
One of the widely suggested ways to eliminate or reduce the side effects is to develop frameworks that help doctors make the best decisions. According to Williams et al. (2018), the World Health Organization (WHO) provides doctors with a guide on how to administer antimicrobial treatments to children and mitigate the rapid increase of antimicrobial resistance in children (Williams et al.,2018).
Williams et al. (2018) “systematically reviewed studies of antimicrobial resistance among children in sub-Saharan Africa since 2005” (p. 33). Empowering clinicians to make the right decisions can result in a reduction in the incidences of resistance to antibiotics. The other aspect that has been mentioned is the need to increase surveillance to understand the prevalence of AMR and develop appropriate measures. Williams et al. (2018) note that developing countries face a challenge in addressing the long-term effects of AMR due to the lack of surveillance.
Constant antibiotic usage can affect the gut microbiota, which can lead to reduced immunity. Holota et al. (2019) investigated the effects of antibiotic therapy and found that there was a correlation between antibiotic-associated disturbance and the development of inflammatory diseases. The authors conducted an experimental study using rats that were treated daily for 14 days with antibiotic ceftriaxone (Holota et al., 2019). The study also found that patients who had been exposed to antibiotics had a higher incidence of C-reactive protein, which shows heightened inflammation (Holota et al., 2019). The findings are backed by another study that analyzed the relationship between the use of antibiotics and obesity.
In the course of a literature search, the sources that link the use of antibiotics and obesity were identified. Leong et al. (2018) research articles showed that young children had a higher risk of weight gain due to recurrent use of antibiotics. The study also indicated that antibiotics increased obesity by altering the gut microbiome (Leong et al., 2018).
The conclusions in the two papers are drawn from experiments with rats, which show that antibiotic use impacts weight gain. Certain long-term effects that are attributed to antimicrobial treatment may be a result of infectious diseases. According to Leong et al. (2018), the presence of an infection in children or adolescents is directly related to an increase in the odds of obesity. This indicates that there is a need to focus on both the causative agent and the potential effects to generate better insights into the type of treatments to provide to patients.
The scientific literature notes that, at the moment, there is a limited number of studies on the use of antibiotics in the treatment of children. Vazouras et al. (2020) aimed to “describe antibiotic prescribing patterns and antimicrobial resistance rates in hospitalized children with febrile and afebrile urinary tract infections” (p. 4). By using 230 patients with urinary tract infections and compiling antibiotic prescriptions and antibiograms, the authors obtained evidence of a more substantial bacterium resistant to some antibiotics. Thus, they pointed out the need to introduce monitoring and antimicrobial stewardship programs to limit the occurrence of antibiotic rejection in children.
During the coronavirus pandemic, the use of antimicrobial medicines for the treatment of children has also become particularly widespread and used. Peng et al. (2020) used a Cox proportional hazards regression analysis to gain the most valuable information. A limited amount of medications that can be used for minors was determined, but they were effective in helping children with coronavirus. On the other hand, it was noted that further research is required because of the gap in this area.
Of particular importance is gaining awareness about the difference in the length of treatment of patients with antibiotics. Kuitunen et al. (2023) conducted a meta-analysis “to compare short antibiotic treatment (3-5 days) with longer treatment (7-10 days) among children aged ≥6 months” (p. 1123). Using the results of this study and scientific data, the authors concluded that shorter treatment periods are more effective in treating children with community-acquired pneumonia. On the other hand, clearly monitored care with these medications for a longer time can also show positive results but cause more risks.
In addition to resistance, children may also have allergic reactions to certain drugs, which greatly affects the course of treatment. Süleyman et al. (2022) “case-controlled study, we examined 15 patients with CF who had been confirmed with an antibiotic allergy” (p. 2622). After studying a sample of forty-five patients, the authors received confirmation that beta-lactam antibiotic allergy is one of the most common among children.
Acute otitis media refers to the type of infections that most often lead minors to treatment with antibiotics. Mathe et al. (2019) conducted a “systematic review and meta-analysis of bacterial prevalence and antimicrobial resistance in studies of pediatric acute otitis media” (p. 102). Thus, they gained knowledge about the possible criteria for the occurrence of resistance and pointed out the need for this kind of research for improved antimicrobial stewardship. The seriousness of this issue is that it can lead to a long search for alternative treatment or complete treatment failure.
Conclusion
In conclusion, the issue of antimicrobial treatment in children has elicited different insights from various researchers: There are indications that the use of antibiotics has helped eliminate the mortality of children for certain infectious diseases. However, the continuous use of antibiotics has been found to increase resistance and negatively affect the gut microbiota, and the development of antimicrobial resistance is a significant issue that does not have a comprehensive solution.
According to the literature study, children are more likely to contract infectious infections, which puts them at risk for acquiring AMR. The analysis has shown that doctors have a role in ensuring that patients do not develop antimicrobial resistance: clinicians need to understand the potential risks and benefits of a certain medication before prescribing it to patients. Developing enhanced surveillance systems and making antibiotics available via prescription only can ensure the elimination of AMR globally.
References
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Kuitunen, I., Jääskeläinen, J., Korppi, M., & Renko, M. (2023). Antibiotic Treatment Duration for Community-Acquired Pneumonia in Outpatient Children in High-Income Countries—A Systematic Review and Meta-Analysis. Clinical Infectious Diseases, 76(3), e1123-e1128. Web.
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Süleyman, A., Tamay, Z., & Güler, N. (2022). Antibiotic allergy in children with cystic fibrosis: A retrospective case–control study. Pediatric Pulmonology, 57(11), 2622-2628. Web.
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