Inhaled Antibiotics for the Prevention of Respiratory Tract Infections in Children With a Tracheostomy.

Autor:	Jutras C; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada., Autmizguine J; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada.; Department of Pharmacology and Physiology, Université de Montréal, Montréal, QC, Canada.; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada., Chomton M; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada., Marquis C; Department of Pharmacy, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada., Nguyen TT; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada.; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada., Roumeliotis N; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada., Emeriaud G; Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, QC, Canada.; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2021 Feb 05; Vol. 9, pp. 633039. Date of Electronic Publication: 2021 Feb 05 (Print Publication: 2021).
DOI:	10.3389/fped.2021.633039
Abstrakt:	Objective: To describe the use of prophylactic inhaled antibiotics in children with a tracheostomy and assess if its use is associated with a reduction in exposition to broad-spectrum antibiotics and a lower risk of acquired respiratory tract infections. Methods: A case series study was performed in a tertiary care university affiliated hospital. All consecutive children (<18 years old) with a tracheostomy, hospitalized between January 2004 and November 2016, and treated with prophylactic inhaled antibiotics were identified. We analyzed the 3 month- period before and after initiation of prophylactic inhaled antibiotics and described exposure to broad spectrum antibiotics, the number of respiratory tract infections and the associated adverse events. Results: Six children (median age: 11 months, range: 8-100) were included. One received colimycin, 3 received tobramycin and 2 were treated with both antibiotics in alternance. The median duration of treatment was 74 days (22-173) with one patient still being treated at the end of the study. Patients were exposed to systemic antibiotics for 18 days (2-49) in the 3 months preceding the treatment vs. 2 days (0-15) in the 3 months following the treatment initiation ( p = 0.115). The number of respiratory tract infections went from median of 2 (0-3) to 1 (0-1) during the same periods ( p = 0.07). Adverse events most commonly reported were cough ( n = 2) and increased respiratory secretions post-inhalation ( n = 4). Only one new bacterial resistance was observed. Conclusions: This series of consecutive cases underlines the need for future studies evaluating the potential benefit of prophylactic inhaled antibiotics in children with a tracheostomy. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Jutras, Autmizguine, Chomton, Marquis, Nguyen, Roumeliotis and Emeriaud.)
Databáze:	MEDLINE
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