Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise.
<h4>Objective</h4>To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children.<h4>Design</h4>Anonymous, online practice survey using five common pediatr...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0272021 |
| _version_ | 1818492290229862400 |
|---|---|
| author | Sandra Pong Robert A Fowler Srinivas Murthy Jeffrey M Pernica Elaine Gilfoyle Patricia Fontela Nicholas Mitsakakis Asha C Bowen Winnie Seto Michelle Science James S Hutchison Philippe Jouvet Asgar Rishu Nick Daneman |
| author_facet | Sandra Pong Robert A Fowler Srinivas Murthy Jeffrey M Pernica Elaine Gilfoyle Patricia Fontela Nicholas Mitsakakis Asha C Bowen Winnie Seto Michelle Science James S Hutchison Philippe Jouvet Asgar Rishu Nick Daneman |
| author_sort | Sandra Pong |
| collection | DOAJ |
| description | <h4>Objective</h4>To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children.<h4>Design</h4>Anonymous, online practice survey using five common pediatric-based case scenarios of bloodstream infections.<h4>Setting</h4>Pediatric intensive care units in Canada, Australia and New Zealand.<h4>Participants</h4>Pediatric intensivists, nurse practitioners, ID physicians and pharmacists.<h4>Main outcome measures</h4>Recommended treatment durations for common infectious syndromes associated with bloodstream infections and willingness to enrol patients into a trial to study treatment duration.<h4>Results</h4>Among 136 survey respondents, most recommended at least 10 days antibiotics for bloodstream infections associated with: pneumonia (65%), skin/soft tissue (74%), urinary tract (64%) and intra-abdominal infections (drained: 90%; undrained: 99%). For central vascular catheter-associated infections without catheter removal, over 90% clinicians recommended at least 10 days antibiotics, except for infections caused by coagulase negative staphylococci (79%). Recommendations for at least 10 days antibiotics were less common with catheter removal. In multivariable linear regression analyses, lack of source control was significantly associated with longer treatment durations (+5.2 days [95% CI: 4.4-6.1 days] for intra-abdominal infections and +4.1 days [95% CI: 3.8-4.4 days] for central vascular catheter-associated infections). Most clinicians (73-95%, depending on the source of bloodstream infection) would be willing to enrol patients into a trial of shorter versus longer antibiotic treatment duration.<h4>Conclusions</h4>The majority of clinicians currently recommend at least 10 days of antibiotics for most scenarios of bloodstream infections in critically ill children. There is practice heterogeneity in self-reported treatment duration recommendations among clinicians. Treatment durations were similar across different infectious syndromes. Under appropriate clinical conditions, most clinicians would be willing to enrol patients into a trial of shorter versus longer treatment for common syndromes associated with bloodstream infections. |
| first_indexed | 2024-12-10T17:41:05Z |
| format | Article |
| id | doaj.art-28f3b04bc279448ca28fc3f18db21854 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T17:41:05Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-28f3b04bc279448ca28fc3f18db218542022-12-22T01:39:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027202110.1371/journal.pone.0272021Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise.Sandra PongRobert A FowlerSrinivas MurthyJeffrey M PernicaElaine GilfoylePatricia FontelaNicholas MitsakakisAsha C BowenWinnie SetoMichelle ScienceJames S HutchisonPhilippe JouvetAsgar RishuNick Daneman<h4>Objective</h4>To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children.<h4>Design</h4>Anonymous, online practice survey using five common pediatric-based case scenarios of bloodstream infections.<h4>Setting</h4>Pediatric intensive care units in Canada, Australia and New Zealand.<h4>Participants</h4>Pediatric intensivists, nurse practitioners, ID physicians and pharmacists.<h4>Main outcome measures</h4>Recommended treatment durations for common infectious syndromes associated with bloodstream infections and willingness to enrol patients into a trial to study treatment duration.<h4>Results</h4>Among 136 survey respondents, most recommended at least 10 days antibiotics for bloodstream infections associated with: pneumonia (65%), skin/soft tissue (74%), urinary tract (64%) and intra-abdominal infections (drained: 90%; undrained: 99%). For central vascular catheter-associated infections without catheter removal, over 90% clinicians recommended at least 10 days antibiotics, except for infections caused by coagulase negative staphylococci (79%). Recommendations for at least 10 days antibiotics were less common with catheter removal. In multivariable linear regression analyses, lack of source control was significantly associated with longer treatment durations (+5.2 days [95% CI: 4.4-6.1 days] for intra-abdominal infections and +4.1 days [95% CI: 3.8-4.4 days] for central vascular catheter-associated infections). Most clinicians (73-95%, depending on the source of bloodstream infection) would be willing to enrol patients into a trial of shorter versus longer antibiotic treatment duration.<h4>Conclusions</h4>The majority of clinicians currently recommend at least 10 days of antibiotics for most scenarios of bloodstream infections in critically ill children. There is practice heterogeneity in self-reported treatment duration recommendations among clinicians. Treatment durations were similar across different infectious syndromes. Under appropriate clinical conditions, most clinicians would be willing to enrol patients into a trial of shorter versus longer treatment for common syndromes associated with bloodstream infections.https://doi.org/10.1371/journal.pone.0272021 |
| spellingShingle | Sandra Pong Robert A Fowler Srinivas Murthy Jeffrey M Pernica Elaine Gilfoyle Patricia Fontela Nicholas Mitsakakis Asha C Bowen Winnie Seto Michelle Science James S Hutchison Philippe Jouvet Asgar Rishu Nick Daneman Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. PLoS ONE |
| title | Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. |
| title_full | Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. |
| title_fullStr | Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. |
| title_full_unstemmed | Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. |
| title_short | Antibiotic treatment duration for bloodstream infections in critically ill children-A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise. |
| title_sort | antibiotic treatment duration for bloodstream infections in critically ill children a survey of pediatric infectious diseases and critical care clinicians for clinical equipoise |
| url | https://doi.org/10.1371/journal.pone.0272021 |
| work_keys_str_mv | AT sandrapong antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT robertafowler antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT srinivasmurthy antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT jeffreympernica antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT elainegilfoyle antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT patriciafontela antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT nicholasmitsakakis antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT ashacbowen antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT winnieseto antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT michellescience antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT jamesshutchison antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT philippejouvet antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT asgarrishu antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise AT nickdaneman antibiotictreatmentdurationforbloodstreaminfectionsincriticallyillchildrenasurveyofpediatricinfectiousdiseasesandcriticalcarecliniciansforclinicalequipoise |