New era for orally administered antibiotics: use of sequential parenteral-oral antibiotic therapy for serious infectious diseases of infants and children.

Removal of the intravenous line, improvement of attitude and appetite and early discharge from the hospital can be achieved when sequential parenteral-oral antibiotic therapy is used appropriately to treat children with certain moderate to severe infections. Such antibiotic regimens are potentially indicated for suppurative skeletal infections, bacterial endocarditis, pneumonia with or without empyema, pyelonephritis and, perhaps, meningitis. To be effective, serum bactericidal activity against the causative pathogen after oral therapy must be comparable to that achieved after parenteral administration. Patient and parent compliance, adequate absorption and drug interactions are some of the factors that should be considered to assure a successful course of parenteral-oral antibiotic therapy.