Optimisation de l'antibiothérapie chez les enfants atteints d'infections causées par des bactéries résistantes au traitement de première ligne

 

Julie Autmizguine

Centre de recherche du CHU Ste-Justine

 

Domaine : maladies infectieuses et immunitaires

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2016-2017

Severe infection is one of the main causes of disease in hospitalized children and can be deadly. The emergence of drug resistance among bacteria limits the physician's ability to treat these infections, especially with the lack of novel antibiotics approved for children. To overcome this challenge, there is a need to reassess treatment strategies. Alternative strategies may consist in modifying dosing regimen of existing antibiotics such as prolonging the time during which the drug is infused (piperacillin-tazobactam infused over 4 hours instead of 30 min). It may also include the use of novel drugs such as linezolid. These alternative treatment strategies cannot be directly extrapolated from adults to children because young children clear drugs from their bodies at a different rate compared with adults.


Objectif # 1: Determine the rate at which children clear piperacillin-tazobactam from their body, and establish how many of those children achieve appropriate concentrations


We will conduct a study in which children from 2 months to 6 years of age, with suspected or confirmed infection, will be administered piperacillin-tazobactam. For each child, we will collect 4 blood samples to describe how the drug is eliminated from the body. We will then calculate how many children enrolled in this study achieve appropriate drug concentrations for different levels of antibiotic resistance.


Objectif #2: Determine the relationship between linezolid side effects and drug concentrations in the blood of young infants


We will retrospectively analyze data of young infants less than 4 months of age, who received linezolid per standard of care. We will then determine if decreased platelet levels which is linezolid's main side effect is related to the level of drug in the infants' blood.

These projects will provide effective and safe dosing recommendations for two antibiotics used in children infected with drug-resistant bacteria.