From the Guidelines
Enterocolitis in a child should be managed with broad-spectrum antibiotics, such as an aminoglycoside-based regimen, a carbapenem, or a b-lactam/b-lactamase–inhibitor combination, along with metronidazole, as recommended by the Surgical Infection Society and the Infectious Diseases Society of America 1. When treating enterocolitis in children, it is crucial to consider the origin of infection, severity of illness, and safety of antimicrobial agents in specific pediatric age groups 1.
- Key considerations include:
- Community-acquired vs healthcare-associated infection
- Severity of symptoms, such as abdominal pain, fever, and vomiting
- Potential allergies or reactions to certain antibiotics
- Acceptable broad-spectrum antimicrobial regimens for pediatric patients with complicated intra-abdominal infection include:
- Aminoglycoside-based regimen
- Carbapenem (imipenem, meropenem, or ertapenem)
- B-lactam/b-lactamase–inhibitor combination (piperacillin-tazobactam or ticarcillin-clavulanate)
- Advanced-generation cephalosporin (cefotaxime, ceftriaxone, ceftazidime, or cefepime) with metronidazole 1 In cases of necrotizing enterocolitis, management involves fluid resuscitation, intravenous broad-spectrum antibiotics, and bowel decompression, with urgent operative intervention if there is evidence of bowel perforation 1.
- Broad-spectrum antibiotics that may be useful in neonates with necrotizing enterocolitis include:
- Ampicillin, gentamicin, and metronidazole
- Ampicillin, cefotaxime, and metronidazole
- Meropenem
- Vancomycin for suspected MRSA or ampicillin-resistant enterococcal infection 1
From the Research
Enterocolitis in Children
- Enterocolitis is a condition that affects the digestive system of children, causing inflammation of the small intestine and colon.
- The treatment of enterocolitis in children depends on the severity of the condition and the underlying cause.
Causes and Risk Factors
- Bacterial infections, such as those caused by invasive bacterial pathogens, can lead to enterocolitis in children 2.
- Other risk factors include the use of formula milk, hyperosmolar feeds, and unrestricted use of high-risk medications 3.
- Children with Hirschsprung disease are also at risk of developing enterocolitis 4.
Treatment Options
- Oral rehydration therapy is a common treatment for mild to moderate dehydration caused by enterocolitis in children 5, 6.
- Intravenous rehydration may be necessary in severe cases of dehydration or when oral rehydration therapy has failed 5, 6.
- Antibiotics may be prescribed to treat bacterial infections that cause enterocolitis 2.
- Probiotics have been shown to be effective in reducing the duration of hospitalization in children with enterocolitis 6.
- A standardized feeding protocol, early initiation of enteral feeding using human milk, and optimization of the osmolality of preterm milk feeds can help reduce the incidence of necrotizing enterocolitis in very low-birth-weight infants 3.
Management and Prevention
- Implementing a triage algorithm and treatment protocol can help reduce hospital admissions in children with Hirschsprung disease and enterocolitis 4.
- Standardizing care and providing timely treatment can help prevent unnecessary hospital admissions and improve outcomes for children with enterocolitis 3, 4.
- Education of caregivers and the treatment team is essential in improving the management and resource utilization of children with enterocolitis 4.