Evaluating the Role ofStaphylococcus aureusNasal PCR in Pediatric Head and Neck Infections
| Autor: | Patrick Kinn, Derek Zhorne, Chandni Patel, Lukasz Weiner, Guru Bhoojhawon, Danelle Wilson |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class business.industry medicine.medical_treatment Incidence (epidemiology) Antibiotics Acute kidney injury Retrospective cohort study medicine.disease Internal medicine Pediatrics Perinatology and Child Health medicine Coinfection Vancomycin Pharmacology (medical) business De-escalation Dialysis medicine.drug |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 26:734-739 |
| ISSN: | 1551-6776 |
| DOI: | 10.5863/1551-6776-26.7.734 |
| Popis: | OBJECTIVEVancomycin is often empirically used in the management of head and neck infections (HNIs) in children. The objective of this study was to determine the utility of Staphylococcus aureus (SA) nasal PCR to facilitate de-escalation of vancomycin for pediatric HNIs.METHODSThis was a single-center, retrospective cohort study of pediatric patients who received empiric intravenous vancomycin for a diagnosis of HNIs between January 2010 and December 2019. Subjects were excluded if they met any of the following: confirmed/suspected coinfection of another site, dialysis, immunocompromised status, admission to the NICU, alternative diagnosis that did not require antibiotics, or readmission for HNIs within 30 days of previous admission. The primary outcome was time to de-escalation of vancomycin. Total duration of antibiotics, treatment failure, hospital length of stay (LOS), and incidence of acute kidney injury (AKI) were also assessed.RESULTSOf the 575 patients identified, 124 patients received an SA nasal PCR. The median time to de-escalation was 39.5 hours in those patients compared with 53.7 hours in patients who did not have a SA nasal PCR (p = 0.002). No difference was noted in total duration of all methicillin-resistant Staphylococcus aureus antibiotics, hospital LOS, treatment failure, and AKI.CONCLUSIONSIn a large cohort of pediatric patients with HNIs, those who underwent testing with an SA nasal PCR spent less time receiving intravenous vancomycin, although their LOS was not significantly reduced. Further investigation is needed to better define the role of SA nasal PCRs in determining antibiotic therapy for HNIs. |
| Databáze: | OpenAIRE |
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