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Nelson's Pediatric Antimicrobial Therapy Updates

February 27, 2024

The following updates have been issued for 2022 Nelson's Pediatric Antimicrobial Therapy, 28th Edition:


AAP Interim COVID-19 Guidance

Because interim COVID guidance continues to evolve at a rapid pace (including potential new therapeutics), we are adding a link to the AAP COVID-19 guidance page (


Mpox (Monkeypox)

Following consultation with the CDC, treatment may be considered in patients experiencing severe disease that prompts hospitalization or in patients likely to experience severe disease (ie, immunocompromised patients, children <8 y, pregnant/breastfeeding women) as follows:

CDC-held Emergency Access Investigational New Drug protocol allows use of tecovirimat, oral and parenteral, for treatment of non–variola Orthopoxvirus infection (eg, mpox).

CDC-held Emergency Access Investigational New Drug Protocol allows use of vaccinia immune globulin intravenous for treatment of non–variola Orthopoxvirus infection (eg, mpox).

Cidofovir and brincidofovir may be effective, but no data exist on either drug for treatment of mpox in humans (; updated October 31, 2022; accessed December 5, 2022).


Ceftolozane/Tazobactam Receives FDA Approval

Ceftolozane/tazobactam was approved by the FDA in April 2022 for all pediatric and adolescent age-groups from birth up to 18 years. Ceftolozane is more active than some of the other antipseudomonal cephalosporins, ceftazidime and cefepime, against Pseudomonas aeruginosa, including some strains that are meropenem resistant. Ceftolozane is also active against most enteric bacilli (eg, Escherichia coli, Klebsiella, Enterobacter), similar to ceftriaxone but with stability to the ampC beta-lactamases that inactivate ceftriaxone and ceftazidime. Ceftolozane is paired with tazobactam (a beta-lactamase inhibitor that has been available with piperacillin for several years), allowing for additional activity against ESBL-producing enteric bacilli but lacking stability to carbapenemases. Although the anaerobic spectrum is quite reasonable, ceftolozane/tazobactam was paired with metronidazole in the initial adult studies for complicated intra-abdominal infection that were designed by Cubist Pharmaceuticals for FDA approval. These adult studies succeeded, so pediatric studies used the same clinical trial design.

Following are the FDA package label indications for pediatrics: complicated intra-abdominal infections, used in combination with metronidazole, and complicated urinary tract infections, including pyelonephritis. Pediatric studies for nosocomial pneumonia, sponsored by Merck, are ongoing.


2024 Nelson's Pediatric Antimicrobial Therapy, 30th Edition

This best-selling and widely used resource on pediatric antimicrobial therapy provides instant access to reliable, up-to-the-minute recommendations for treatment of infectious diseases in children.

Completely updated and revised, the 30th edition of this best-selling reference provides instant access to the latest recommendations for treatment of infectious diseases in children.

New in the 30th Edition

  • Updated multiple drug-resistant gram-negative pathogens treatment recommendations with newly approved antibiotics
  • Newer antibiotics, beyond vancomycin, to treat MRSA infections
  • Updates on children’s influenza, COVID-19, and enterovirus treatments
  • Updates on travelers’ diarrhea
  • Latest guidelines for treatment of invasive pediatric fungal infections
  • New guidelines for treatment of pediatric bacterial arthritis
  • Recommendations on hepatitis C virus and cytomegalovirus treatment options

Visit shopAAP to order 2024 Nelson’s Pediatric Antimicrobial Therapy, 30th Edition today!


Available for separate purchase: Nelson’s 2024 app for iOS!

Nelson Pediatric Abx 2024

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