We evaluated 74 children with previous fecal extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae colonization who were hospitalized and receiving a course of antibiotic therapy for suspected infection. Sixty-four patients (86.5%) received a carbapenem agent. Only 3 patients were infected with an ESBL-producing Enterobacteriaceae. Sixty-one (95%) initial antibiotic courses were considered excessive and required deescalation; however, deescalation was accomplished in only 38 patients (62%). This suggests the need for an ESBL control program to decrease carbapenem use and thereby limit carbapenem resistance in gram-negative bacilli.
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