Factors associated with increased risk in inappropriate empiric antibiotic treatment of childhood bacteraemia.

Autor: Ashkenazi, Shai, Samra, Zmira, Konisberger, Hana, Drucker, Moshe, Leibovici, Leonard, Ashkenazi, S, Samra, Z, Konisberger, H, Drucker, M M, Leibovici, L
Zdroj: European Journal of Pediatrics; 1996, Vol. 155 Issue 7, p545-550, 6p
Abstrakt: Unlabelled: To identify bacteraemic children who are at increased risk of inappropriate empiric antibiotic therapy, we performed univariate and multivariate analyses of prospectively-studied bacteraemic episodes. Appropriateness of therapy was defined according to the in vitro susceptibility of the isolate. Inappropriate empiric therapy was found in 38% of 516 bacteraemic episodes and was associated with higher mortality. The rate of inappropriate treatment was lower in neonates and infants (28% and 33%, respectively) but higher in children 1- to 5-years old (51%, P = 0.0029). The rate was dependent on the source of bacteraemia (range, 18%-70%, P = 0.0092), underlying conditions (range, 26%-53%, P = 0.0001), the specific paediatric section in which the child was hospitalized (range, 24%-70%, P = 0.0002), and the causative micro-organism (range, 15%-75%, P < 0.0001). Four clinical variables that independently and significantly affected the rate of inappropriate antibiotic treatment were identified by multivariate stepwise logistic regression analysis (odds ratios in parentheses): hospital-acquired bacteraemia (2.3), age of 1- to 5-years (2.1), cytotoxic therapy (1.8) and presence of central i.v. line (1.6).Conclusion: We defined bacteraemic children who are at risk of inappropriate empiric antibiotic therapy. Special efforts are needed to improve their treatment and consequently their outcome. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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