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The role of combination antibiotic therapy — using a β-lactam antibiotic plus an aminoglycoside rather than a β-lactam alone — as culture-directed therapy for gram-negative bacteremia is unsettled in pediatric practice, although most studies in adults show no advantage with the combination. In a retrospective study involving pediatric patients at a single major medical center in the U.S., researchers examined 10 years of data to determine whether combination therapy affects survival and whether it increases the risk for renal injury.
They identified 879 children aged ≤18 who were admitted between 2002 and 2011 with blood cultures growing species of Enterobacteriaceae, Pseudomonas, or Acinetobacter. The most commonly isolated organisms were K…