Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Kolberg, L; Khanijau, A; van, der, Velden, FJS; Herberg, J; De, T; Galassini, R; Cunnington, AJ; Wright, VJ; Shah, P; Kaforou, M; Wilson, C; Kuijpers, T; Martinón-Torres, F; Rivero-Calle, I; Moll, H; Vermont, C; Pokorn, M; Kolnik, M; Pollard, AJ; Agyeman, PKA; Schlapbach, LJ; Tsolia, MN; Yeung, S; Zavadska, D; Zenz, W; Schweintzger, NA; van, der, Flier, M; de, Groot, R; Usuf, E; Voice, M; Calvo-Bado, L; Mallet, F; Fidler, K; Levin, M; Carrol, ED; Emonts, M; von, Both, U, , PERFORM, Consortium.
Raising AWaRe-ness of Antimicrobial Stewardship Challenges in Pediatric Emergency Care: Results from the PERFORM Study Assessing Consistency and Appropriateness of Antibiotic Prescribing Across Europe.
Clin Infect Dis. 2024; 78(3):526-534
Doi: 10.1093/cid/ciad615
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- Co-Autor*innen der Med Uni Graz
- Schweintzger Nina
- Zenz Werner
- Study Group Mitglieder der Med Uni Graz:
- Bauchinger Sebastian
- Baumgart Hinrich
- Benesch Martin
- Binder Alexander
- Eber Ernst
- Gallistl Siegfried
- Gores Gunther
- Haidl Harald
- Hauer Almuthe
- Keldorfer Markus
- Kohlfürst Daniela
- Kohlmaier Benno
- Krenn Larissa
- Leitner Manuel
- Löffler Sabine
- Niedrist Tobias Josef
- Nordberg Gudrun
- Pfleger Andreas
- Pfurtscheller Klaus
- Pilch Heidemarie
- Pölz Lena
- Rajic Glorija
- Roedl Siegfried
- Sagmeister Manfred Gerald
- Skrabl-Baumgartner Andrea
- Sperl Matthias
- Stampfer Laura
- Strenger Volker
- Till Holger
- Trobisch Andreas
- Zurl Christoph Johann
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- Abstract:
- BACKGROUND: Optimization of antimicrobial stewardship is key to tackling antimicrobial resistance, which is exacerbated by overprescription of antibiotics in pediatric emergency departments (EDs). We described patterns of empiric antibiotic use in European EDs and characterized appropriateness and consistency of prescribing. METHODS: Between August 2016 and December 2019, febrile children attending EDs in 9 European countries with suspected infection were recruited into the PERFORM (Personalised Risk Assessment in Febrile Illness to Optimise Real-Life Management) study. Empiric systemic antibiotic use was determined in view of assigned final "bacterial" or "viral" phenotype. Antibiotics were classified according to the World Health Organization (WHO) AWaRe classification. RESULTS: Of 2130 febrile episodes (excluding children with nonbacterial/nonviral phenotypes), 1549 (72.7%) were assigned a bacterial and 581 (27.3%) a viral phenotype. A total of 1318 of 1549 episodes (85.1%) with a bacterial and 269 of 581 (46.3%) with a viral phenotype received empiric systemic antibiotics (in the first 2 days of admission). Of those, the majority (87.8% in the bacterial and 87.0% in the viral group) received parenteral antibiotics. The top 3 antibiotics prescribed were third-generation cephalosporins, penicillins, and penicillin/β-lactamase inhibitor combinations. Of those treated with empiric systemic antibiotics in the viral group, 216 of 269 (80.3%) received ≥1 antibiotic in the "Watch" category. CONCLUSIONS: Differentiating bacterial from viral etiology in febrile illness on initial ED presentation remains challenging, resulting in a substantial overprescription of antibiotics. A significant proportion of patients with a viral phenotype received systemic antibiotics, predominantly classified as WHO Watch. Rapid and accurate point-of-care tests in the ED differentiating between bacterial and viral etiology could significantly improve antimicrobial stewardship.
- Find related publications in this database (using NLM MeSH Indexing)
- Child - administration & dosage
- Humans - administration & dosage
- Anti-Bacterial Agents - therapeutic use
- Antimicrobial Stewardship - methods
- Drug Prescriptions - administration & dosage
- Europe - administration & dosage
- Emergency Service, Hospital - administration & dosage
- Fever - diagnosis, drug therapy
- Penicillins - therapeutic use
- Find related publications in this database (Keywords)
- antimicrobial stewardship
- pediatric emergency care
- antibiotic prescription
- AWaRe
- infectious diseases