Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA)
Background: Increasing antibiotic resistance to WHO-recommended first- and second-line treatments of pediatric sepsis requires adaptation of prescribing guidelines. We discuss the potential and limitations of a weighted-incidence syndromic combination antibiogram (WISCA) as a practical tool for inco...
| मुख्य लेखकों: | , , , |
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| अन्य लेखक: | |
| स्वरूप: | Journal article |
| भाषा: | English |
| प्रकाशित: |
Taylor and Francis
2021
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| _version_ | 1826307463635271680 |
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| author | Cook, A Sharland, M Yau, Y Bielicki, J |
| author2 | PediBSI Group |
| author_facet | PediBSI Group Cook, A Sharland, M Yau, Y Bielicki, J |
| author_sort | Cook, A |
| collection | OXFORD |
| description | Background: Increasing antibiotic resistance to WHO-recommended first- and second-line treatments of pediatric sepsis requires adaptation of prescribing guidelines. We discuss the potential and limitations of a weighted-incidence syndromic combination antibiogram (WISCA) as a practical tool for incorporating local microbiology data when assessing empiric coverage of commonly used antibiotics.
Research design and methods: A brief questionnaire of 18 clinically significant isolates from pediatric blood cultures (Jan-Dec 2018) was sent to a global network of pediatric hospitals in July 2019. Weighted coverage estimates of non-antipseudomonal third-generation cephalosporins (3GC) and meropenem were estimated using Monte–Carlo simulation for each site reporting >100 isolates.
Results: 52 hospitals in 23 countries in 5 WHO regions responded to the questionnaire; 13 sites met the sample size requirement. The most common isolates were S. aureus, Klebsiella spp., E. coli and Enterococcus spp. Coverage of 3GC ranged from 39% [95%CrI: 34–43%] to 73% (two sites: [95%CrI: 65–80%]; [95%CrI: 68–86%]) and meropenem coverage ranged from 54% [95%CrI: 47–60%] to 88% [95%CrI:84–91%].
Conclusions: A WISCA is a data-driven, clinically intuitive tool that can be used to compare empiric antibiotic regimens for pediatric sepsis using existing large datasets. The estimates can be further refined using more complex meta-analytical methods and patient characteristics.
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| first_indexed | 2024-03-07T07:03:30Z |
| format | Journal article |
| id | oxford-uuid:9b3a1a2a-71db-46e0-8596-5ac297cfdf06 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:03:30Z |
| publishDate | 2021 |
| publisher | Taylor and Francis |
| record_format | dspace |
| spelling | oxford-uuid:9b3a1a2a-71db-46e0-8596-5ac297cfdf062022-04-19T07:41:22ZImproving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9b3a1a2a-71db-46e0-8596-5ac297cfdf06EnglishSymplectic ElementsTaylor and Francis2021Cook, ASharland, MYau, YBielicki, JPediBSI GroupTurner, PBackground: Increasing antibiotic resistance to WHO-recommended first- and second-line treatments of pediatric sepsis requires adaptation of prescribing guidelines. We discuss the potential and limitations of a weighted-incidence syndromic combination antibiogram (WISCA) as a practical tool for incorporating local microbiology data when assessing empiric coverage of commonly used antibiotics. Research design and methods: A brief questionnaire of 18 clinically significant isolates from pediatric blood cultures (Jan-Dec 2018) was sent to a global network of pediatric hospitals in July 2019. Weighted coverage estimates of non-antipseudomonal third-generation cephalosporins (3GC) and meropenem were estimated using Monte–Carlo simulation for each site reporting >100 isolates. Results: 52 hospitals in 23 countries in 5 WHO regions responded to the questionnaire; 13 sites met the sample size requirement. The most common isolates were S. aureus, Klebsiella spp., E. coli and Enterococcus spp. Coverage of 3GC ranged from 39% [95%CrI: 34–43%] to 73% (two sites: [95%CrI: 65–80%]; [95%CrI: 68–86%]) and meropenem coverage ranged from 54% [95%CrI: 47–60%] to 88% [95%CrI:84–91%]. Conclusions: A WISCA is a data-driven, clinically intuitive tool that can be used to compare empiric antibiotic regimens for pediatric sepsis using existing large datasets. The estimates can be further refined using more complex meta-analytical methods and patient characteristics. |
| spellingShingle | Cook, A Sharland, M Yau, Y Bielicki, J Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title | Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title_full | Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title_fullStr | Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title_full_unstemmed | Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title_short | Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA) |
| title_sort | improving empiric antibiotic prescribing in pediatric bloodstream infections a potential application of weighted incidence syndromic combination antibiograms wisca |
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