Please use this identifier to cite or link to this item:
10.1093/cid/ciad615
Title: | Raising AWaRe-ness of antimicrobial stewardship challenges in pediatric emergency care : results from the PERFORM study assessing consistency and appropriateness of antibiotic prescribing across Europe |
Authors: | Kolberg, Laura Khanijau, Aakash van der Velden, Fabian J S Herberg, Jethro Zavadska, Dace PERFORM consortium Balode, Anda Bārzdiņa, Arta Gardovska, Dace Grope, Ilze Meiere, Anija Nokalna, Ieva Rīga Stradiņš University |
Keywords: | antimicrobial stewardship;;pediatric emergency care;antibiotic prescription;AWaRe;infectious diseases;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database |
Issue Date: | 15-Mar-2024 |
Citation: | Kolberg , L , Khanijau , A , van der Velden , F J S , Herberg , J , Zavadska , D , PERFORM consortium , Balode , A , Bārzdiņa , A , Gardovska , D , Grope , I , Meiere , A & Nokalna , I 2024 , ' Raising AWaRe-ness of antimicrobial stewardship challenges in pediatric emergency care : results from the PERFORM study assessing consistency and appropriateness of antibiotic prescribing across Europe ' , Clinical Infectious Diseases , pp. 526-534 . https://doi.org/10.1093/cid/ciad615 |
Abstract: | OBJECTIVES: Optimization of antimicrobial stewardship (AMS) is key to tackling antimicrobial resistance (AMR), which is exacerbated by over-prescription of antibiotics in pediatric Emergency Departments (EDs). We described patterns of empiric antibiotic use in European EDs, and characterized appropriateness and consistency of prescribing. METHODS: Between August 2016 and December 2019 febrile children attending the ED in nine European countries with suspected infection were recruited into the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management) study. Empiric systemic antibiotic use was determined in view of assigned final 'bacterial' or 'viral' phenotype. Antibiotics were classified according to WHO AWaRe. RESULTS: Of 2130 febrile episodes (excluding children with non-bacterial/non-viral phenotypes), 1549 (72.7%) were assigned a 'bacterial' and 581 (27.3%) a 'viral' phenotype. A total of 1318/1549 (85.1%) episodes with a 'bacterial' and 269/581 (46.3%) with a 'viral' phenotype received empiric systemic antibiotics (first two days of admission). Of those, the majority (87.8% in 'bacterial' and 87.0% in 'viral' group) received parenteral antibiotics. The top three antibiotics prescribed were third-generation cephalosporins, penicillins and penicillin/beta-lactamase inhibitor combinations. Of those treated with empiric systemic antibiotics in the 'viral' group 216/269 (80.3%) received ≥ one Watch antibiotic. CONCLUSIONS: Differentiating bacterial from viral etiology in febrile illness on initial ED presentation remains challenging, resulting in a substantial over-prescription of antibiotics. A significant proportion of patients with a 'viral' phenotype received systemic antibiotics, predominantly classified as WHO Watch. Rapid and accurate point-of-care tests in the ED differentiating between bacterial and viral etiology, could significantly improve AMS. |
Description: | © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. |
DOI: | 10.1093/cid/ciad615 |
ISSN: | 1058-4838 |
Appears in Collections: | Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure |
Files in This Item:
File | Size | Format | |
---|---|---|---|
Raising_AWaRe-ness_of_Antimicrobial.pdf | 845.95 kB | Adobe PDF | View/Open![]() |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.