In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 7 ( 2022-7-26), p. e0272021-
Abstract:
To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children. Design Anonymous, online practice survey using five common pediatric-based case scenarios of bloodstream infections. Setting Pediatric intensive care units in Canada, Australia and New Zealand. Participants Pediatric intensivists, nurse practitioners, ID physicians and pharmacists. Main outcome measures Recommended treatment durations for common infectious syndromes associated with bloodstream infections and willingness to enrol patients into a trial to study treatment duration. Results Among 136 survey respondents, most recommended at least 10 days antibiotics for bloodstream infections associated with: pneumonia (65%), skin/soft tissue (74%), urinary tract (64%) and intra-abdominal infections (drained: 90%; undrained: 99%). For central vascular catheter-associated infections without catheter removal, over 90% clinicians recommended at least 10 days antibiotics, except for infections caused by coagulase negative staphylococci (79%). Recommendations for at least 10 days antibiotics were less common with catheter removal. In multivariable linear regression analyses, lack of source control was significantly associated with longer treatment durations (+5.2 days [95% CI: 4.4–6.1 days] for intra-abdominal infections and +4.1 days [95% CI: 3.8–4.4 days] for central vascular catheter-associated infections). Most clinicians (73–95%, depending on the source of bloodstream infection) would be willing to enrol patients into a trial of shorter versus longer antibiotic treatment duration. Conclusions The majority of clinicians currently recommend at least 10 days of antibiotics for most scenarios of bloodstream infections in critically ill children. There is practice heterogeneity in self-reported treatment duration recommendations among clinicians. Treatment durations were similar across different infectious syndromes. Under appropriate clinical conditions, most clinicians would be willing to enrol patients into a trial of shorter versus longer treatment for common syndromes associated with bloodstream infections.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0272021
DOI:
10.1371/journal.pone.0272021.g001
DOI:
10.1371/journal.pone.0272021.g002
DOI:
10.1371/journal.pone.0272021.g003
DOI:
10.1371/journal.pone.0272021.t001
DOI:
10.1371/journal.pone.0272021.t002
DOI:
10.1371/journal.pone.0272021.t003
DOI:
10.1371/journal.pone.0272021.s001
DOI:
10.1371/journal.pone.0272021.s002
DOI:
10.1371/journal.pone.0272021.s003
DOI:
10.1371/journal.pone.0272021.s004
DOI:
10.1371/journal.pone.0272021.s005
DOI:
10.1371/journal.pone.0272021.s006
DOI:
10.1371/journal.pone.0272021.s007
DOI:
10.1371/journal.pone.0272021.s008
DOI:
10.1371/journal.pone.0272021.s009
DOI:
10.1371/journal.pone.0272021.r001
DOI:
10.1371/journal.pone.0272021.r002
DOI:
10.1371/journal.pone.0272021.r003
DOI:
10.1371/journal.pone.0272021.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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