Early antibiotics use in young infants with invasive bacterial infection visiting emergency department, a single medical center's experience

Huang, Ying‐Hsien; Yan, Jia-Huei; Kuo, Kuang-Che; Wu, Woei-Cherng; Su, Chih-Min; Chiu, I-Min

doi:10.1016/j.pedneo.2019.08.003

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…We report a high prevalence of SBIs (23.3%) and IBIs (4.3%) in our cohort. This is higher than that reported by other studies, with a SBI prevalence of 5-15% (32) and an IBI prevalence of 2.3-3.3% (12,33). We recognize important health service differences in our study population.…”

Section: Discussioncontrasting

confidence: 66%

“…The Surviving Sepsis Campaign (SSC) International Guidelines recommend starting antibiotics as soon as possible, within 1 h of recognizing a child with septic shock, or within 3 h of recognizing sepsis-associated organ dysfunction without shock (9). Early administration of antibiotics, has been demonstrated to reduce subsequent resource utilization, including progression to organ dysfunction, hospital length of stay (LOS), and mortality (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Delays in Time-To-Antibiotics for Young Febrile Infants With Serious Bacterial Infections: A Prospective Single-Center Study

et al. 2022

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IntroductionFear of missed serious bacterial infections (SBIs) results in many febrile young infants receiving antibiotics. We aimed to compare the time to antibiotics between infants with SBIs and those without.Materials and MethodsWe recruited febrile infants ≤ 90 days old seen in the emergency department (ED) between December 2017 and April 2021. SBI was defined as (1) urinary tract infection, (2) bacteremia or (3) bacterial meningitis. We compared the total time (median with interquartile range, IQR) from ED arrival to infusion of antibiotics, divided into (i) time from triage to decision for antibiotics and (ii) time from decision for antibiotics to administration of antibiotics.ResultsWe analyzed 81 and 266 infants with and without SBIs. Median age of those with and without SBIs were 44 (IQR 19–72) and 29 (IQR 7–56) days, respectively (p = 0.002). All infants with SBIs and 168/266 (63.2%) infants without SBIs received antibiotics. Among 249 infants who received antibiotics, the median total time from ED arrival to infusion of antibiotics was 277.0 (IQR 236.0–385.0) mins for infants with SBIs and 304.5 (IQR 238.5–404.0) mins for those without (p = 0.561). The median time to decision for antibiotics was 156.0 (IQR 115.0–255.0) mins and 144.0 (IQR 105.5–211.0) mins, respectively (p = 0.175). Following decision for antibiotics, infants with SBIs received antibiotics much faster compared to those without [107.0 (IQR 83.0–168.0) vs. 141.0 (94.0–209.5) mins, p = 0.017].ConclusionThere was no difference in total time taken to antibiotics between infants with SBIs and without SBIs. Both recognition and administration delays were observed. While all infants with SBIs were adequately treated, more than half of the infants without SBIs received unnecessary antibiotics. This highlights the challenge in managing young febrile infants at initial presentation, and demonstrates the need to examine various aspects of care to improve the overall timeliness to antibiotics.

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Delays in Time-To-Antibiotics for Young Febrile Infants With Serious Bacterial Infections: A Prospective Single-Center Study

et al. 2022

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“…The Lasfe and Matastats analysis of the gender-wise groups demonstrated significantly higher relative abundance of Erysipelotrichaceae_UCG-003 and Anaerostipes in the male group (P<0.05, Figure 2). Some studies pointed out that the relative abundances of Erysipelotrichaceae and Lachnospiraceae were higher in the male and female groups, respectively (21)(22)(23). These two fungal families were not detected in other studies.…”

Section: Discussionmentioning

confidence: 81%

Composition characteristics of the gut microbiota in infants and young children of under 6 years old between Beijing and Japan

Liu¹,

Pan²,

Du³

et al. 2021

Transl Pediatr

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Background: The composition of intestinal flora in Chinese and Japanese has been reported in many studies but that in infants aged 0-6 years old has not been studied yet. Methods:The distribution characteristics of the fecal flora of infants in Beijing (n=84) and Japan (n=53) were analyzed using 16S rRNA gene sequencing analysis.Results: This study showed the higher relative abundance of Erysipelotrichaceae_ UCG-003 and Anaerostipes in male group that of Ruminiclostridium, Eubacterium, Senegalimassilia and Senegalimassilia in female group, especially Senegalimassilia, which was not detected in male group. Defecation trait groups indicated significantly higher relative abundance of Bifidobacterium in abnormal bowel trait group than that in the normal group (P<0.05). The feeding groups' analysis showed significantly higher relative abundance of Bifidobacterium and Enterococcus and lower abundance of Bacteroides and Lacetospirillaceae in the breast-feeding group than that in the formula feeding and mixed-feeding groups. The relative abundance of Parasutterella and Ruminococcaceae_UCG-003 in the halitosis group was significantly higher than that in the normal group.The comparison of cold and fever group and normal group indicated significantly higher relative abundance of Erysipelatoclostridium and lower relative abundance of Lachnospiraceae _UCG-001 in the fever and cold group than that in the normal group (P<0.05). The regional comparison of intestinal flora of Beijing and Japan showed significant increase in the relative abundance of Bacillus, Lactobacillus, Prevotella, megamonas and Veillonella in the intestinal flora of 0-6 years old infants in Beijing.Conclusions: These findings improve the understanding of intestinal bacterial and viral communities of infants from the two Asian countries.

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“…Huang et al and Weiss et al have conducted retrospective studies and reported that the early use of antibiotics led to shortened hospital stays and decreased mortality in pediatric patients with severe sepsis, respectively. 20,21 Several studies have focused on the development of accurate screening tools for identifying the risk of SBIs in low-risk febrile infants. 22e24 Owing to differences in epidemiological and pathogenic features between infants, the study populations were mostly limited to infants aged >1 month.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan

Li¹,

Yin²,

Chen³

et al. 2022

Pediatrics & Neonatology

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Early antibiotics use in young infants with invasive bacterial infection visiting emergency department, a single medical center's experience

Cited by 7 publications

References 23 publications

Delays in Time-To-Antibiotics for Young Febrile Infants With Serious Bacterial Infections: A Prospective Single-Center Study

Delays in Time-To-Antibiotics for Young Febrile Infants With Serious Bacterial Infections: A Prospective Single-Center Study

Composition characteristics of the gut microbiota in infants and young children of under 6 years old between Beijing and Japan

A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan

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