Problems encountered in the management of pediatric infections include treatment failure, which often occurs as a result of antimicrobial-resistant bacterial strains; especially among Pseudomonas aeruginosa.1Chang M.R. Carvalho N.C. Oliveira A.L. Moncada P.M. Moraes B.A. Asensi M.D. Surveillance of pediatric infections in a teaching hospital in Mato Grosso do Sul, Brazil.Braz J Infect Dis. 2003; 7: 149-160Crossref PubMed Scopus (14) Google Scholar, 2Guzman-Blanco M. Casellas J.M. Sader H.S. Bacterial resistance to antimicrobial agents in Latin America. The giant is awakening.Infect Dis Clin North Am. 2000; 14: 67-81Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar For this reason antimicrobial drug activity surveillance is necessary, especially for opportunistic and nosocomial P. aeruginosa.2Guzman-Blanco M. Casellas J.M. Sader H.S. Bacterial resistance to antimicrobial agents in Latin America. The giant is awakening.Infect Dis Clin North Am. 2000; 14: 67-81Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar In Latin America, resistant bacteria are emerging as a real threat in the community as well as in hospital-acquired infections, including pediatric infections.2Guzman-Blanco M. Casellas J.M. Sader H.S. Bacterial resistance to antimicrobial agents in Latin America. The giant is awakening.Infect Dis Clin North Am. 2000; 14: 67-81Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar We reviewed susceptibility data of isolates cultured from hospitalized pediatric patients with suspected community-acquired infections in the West General Hospital (WGH) Caracas, Venezuela between 1997 and 2003. The WGH is a 300-bed general community hospital serving people from west Caracas. Samples were taken before antimicrobial drug therapy was commenced. Samples were processed and organisms identified by traditional methods. In vitro antimicrobial susceptibility of the isolates was assessed by an agar disk diffusion method using Mueller–Hinton agar as recommended by the Clinical and Laboratory Standards Institute (formerly NCCLS). Antipseudomonal third generation cephalosporins and carbapenems are freely prescribed in hospitalized patients but previous antimicrobial drug exposure in this patient series was not measured; there were no chronic conditions reported. During this seven-year period, P. aeruginosa accounted for 137 (4%) of 3425 bacterial isolates from children: 49% from otorrhinolaryngological (ORL) infections, 18% urinary tract infections, 7% skin, and 7% gastrointestinal tract, among others. Overall susceptibility rates are shown in Figure 1. Better antimicrobial activity was observed with ciprofloxacin, meropenem, and imipenem (<5% resistant) than for gentamycin, piperacillin and piperacillin/tazobactam (>10% resistant). For urinary isolates, we found strains resistant to norfloxacin (13%) and gentamycin (8%), but only intermediate resistance to aztreonam, ceftazidime, and ciprofloxacin (8% for each). Susceptibility to imipenem, piperacillin/tazobactam, and tobramycin was 100%. In ORL infections, we found significant resistance to carbenicillin (18%) and some resistance to meropenem (5%) and imipenem (3%) but 100% susceptibility to ciprofloxacin, ofloxacin, and piperacillin/tazobactam. Although multidrug resistance has commonly been reported in nosocomial P. aeruginosa, community-acquired data are less frequently reported. For this reason, epidemiological studies on the prevalence and antimicrobial susceptibility patterns of resistant isolates in different geographical settings, would provide useful information for both empirical treatment of suspected infections and better management of patients. Our results show that in our setting imipenem is still very active against strains of P. aeruginosa in pediatric infections, although other studies have reported higher resistance rates.3Rodríguez A.J. Samaniego D.R. Soskin A. Rodríguez C.N. Canese J. Ortellado de Canese J. et al.Comparative study of antimicrobial resistance of Pseudomonas aeruginosa strains isolated from patients of Caracas and Asunción in a 4-year-period.Chemotherapy. 2002; 48: 164-167Crossref PubMed Scopus (7) Google Scholar, 4Rodríguez C.N. Rodríguez A.J. Niño R.A. Meijomil P. Molina N. García A. et al.Comparative study of antimicrobial resistance of Pseudomonas aeruginosa strains isolated from urinary tract infection in patients from Caracas and Lima.Int J Antimicrob Agents. 2002; 20: 476-477Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Recent studies have reduced safety concerns over the use of quinolones in pediatric patients. Combined with the good antimicrobial activity shown in this and other studies,5Rodriguez A.J. Rodriguez C.N. Meijomil P. Garcia A. Duque C. Molina N. et al.In vitro activity of quinolones against isolates from paediatric urinary tract infections from three Venezuelan centres.Int J Antimicrob Agents. 2001; 17: 531-532Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar this makes them a good empirical choice for community-acquired infections. Local surveillance of antimicrobial activity should be done periodically to guide antimicrobial therapy, especially as carbapenem-resistant P. aeruginosa has been reported as an emerging problem in Latin America.6Gales A.C. Sader H.S. Jones R.N. SENTRY Participants Group (Latin America)Urinary tract infection trends in Latin American hospitals: report from the SENTRY antimicrobial surveillance program (1997–2000).Diagn Microbiol Infect Dis. 2002; 44: 289-299Abstract Full Text Full Text PDF PubMed Scopus (104) Google Scholar This work was presented in part at the 24th International Congress of Chemotherapy, Manila, Philippines, June 4–6, 2005. Abstract No. PP1-035. A.J. Rodríguez-Morales was the recipient of an Inter-American Society for Chemotherapy Travel Award (IASC) to attend this meeting. Conflict of interest: No conflicting interest declared.