Several important advances in antibiotic and antiviral therapy have evolved over the past year, with four areas that are especially noteworthy. First, recent data on antimicrobial pharmacokinetics in very low birth weight infants have provided insights into the development of rational dosing guidelines for this growing patient population. We present these data and make recommendations on dosing regimens for these infants. Second, antibiotics with ever-broadening spectra continue to be developed. We present the clinical trials that evaluate the safety and efficacy of a few of these new agents and comment on their potential uses and drawbacks in the management of infections in children. Third, a better understanding of the pathophysiologic processes involved in bacterial meningitis has led to increasing interest in the use of corticosteroids as adjuvant therapy for the treatment of this infection. We discuss the processes involved and evaluate the clinical trials in which corticosteroid therapy is used for the treatment of bacterial meningitis. Finally, a better understanding of molecular virology has facilitated the advent of new antiviral agents. We discuss the specific role of antiviral therapy in the treatment of cytomegalovirus, human immunodeficiency virus, and varicella infections in infants and children.
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