Use of broad-spectrum antibiotics in children diagnosed with multisystem inflammatory syndrome temporarily associated with SARS-CoV-2 infection in Poland: the MOIS-CoR study.

Autor:	Toczyłowski K; Department of Pediatric Infectious Diseases, Medical University of Białystok, Waszyngtona 17, 15-274 Białystok, Poland., Łasecka-Zadrożna J; Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland., Pałyga-Bysiecka I; Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland., Ludwikowska KM; Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland., Okarska-Napierała M; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland., Dudek N; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland., Afelt A; Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland; Espace-DEV, IRD - Institut de Recherche pour le Développement, 500 rue Jean-François Breton - 34393 Montpellier Cedex 05, France., Suski C; Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland., Kursa MB; Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland., Jackowska T; Department of Pediatrics, The Medical Centre of Postgraduate Education, Cegłowska 80, 01-809 Warsaw, Poland., Kuchar E; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland., Szenborn L; Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland., Mazur-Melewska K; Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Szpitalna 27/33; 60-581 Poznań, Poland. Electronic address: katarzynamelewska@ump.edu.pl.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2022 Sep; Vol. 122, pp. 703-709. Date of Electronic Publication: 2022 Jul 10.
DOI:	10.1016/j.ijid.2022.07.021
Abstrakt:	Objectives: Multisystem inflammatory syndrome in children (MIS-C) is the result of an immune response triggered by a previous exposure to SARS-CoV-2. The clinical presentation of MIS-C overlaps with other life-threatening bacterial infections, in which antimicrobials are the mainstay therapy. The aim of study was to describe the use of antibiotics in children with MIS-C in Poland. Methods: The analysis of 345 children reported from 42 Polish cities to the national MultiOrgan Inflammatory Syndromes COVID-19 Related Study (MOIS-CoR Study) from June 2020 to April 2021. Results: At least one antibiotic was used in 310 (90%) children, mainly third-generation cephalosporin (251/310). Broad-spectrum antibiotics were used in 258 (75%) children and 224 (87%) received this treatment for more than 3 days. Concentrations of serum procalcitonin >2 µg/l and the presence of lower respiratory symptoms were associated with increased odds of receiving any antibiotic. Conclusion: Although bacterial infections in patients with MIS-C are uncommon, we show that MIS-C poses a challenge to clinicians who are faced with the decision to start, continue, or stop antimicrobial therapy. Antibiotic stewardship in patients with MIS-C should be improved to ensure that likely pathogens are treated and that antimicrobials are stopped when bacterial infections are excluded and the diagnosis of MIS-C is made. Competing Interests: Conflict of interest The authors have no competing interests to declare. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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