Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high‐performance liquid chromatography

Toi, Pham Van; Doan, Khanh V.; Minh, Ngo Ngọc Quang; Phuong, Pham; Jong, Menno D. de; Doorn, H. Rogier van; Pouplin, Thomas

doi:10.1002/bmc.4699

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…Regarding the chromatographic columns, other authors have reported C 8 and C 6 columns (Toi et al, 2020;Vercheval et al, 2018;Zhang et al, 2014). In addition, C 18 columns have been reported as well (Alberellos et al, 2015;Foord, 1976;Grupta & Stewart, 1986;Szlagowska et al, 2010).…”

Section: Methods Developmentmentioning

confidence: 87%

A fast, cost‐saving and sensitive method for determination of cefuroxime in plasma by HPLC with ultraviolet detection

Hernandis

Escudero

Pareja

et al. 2021

Biomedical Chromatography

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Section: Methods Developmentmentioning

confidence: 87%

A fast, cost‐saving and sensitive method for determination of cefuroxime in plasma by HPLC with ultraviolet detection

Hernandis

Escudero

Pareja

et al. 2021

Biomedical Chromatography

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“…Antibiotic levels in urine were determined using validated in-house protocols, as described earlier [ 31 ]. The most frequently used antibiotics in the hospital and sold in the pharmacy of Children’s Hospital 1 are listed in S1 Table .…”

Section: Methodsmentioning

confidence: 99%

Antibiotic use and prescription and its effects on Enterobacteriaceae in the gut in children with mild respiratory infections in Ho Chi Minh City, Vietnam. A prospective observational outpatient study

et al. 2020

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Background and objectives Treatment guidelines do not recommend antibiotic use for acute respiratory infections (ARI), except for streptococcal pharyngitis/tonsillitis and pneumonia. However, antibiotics are prescribed frequently for children with ARI, often in absence of evidence for bacterial infection. The objectives of this study were 1) to assess the appropriateness of antibiotic prescriptions for mild ARI in paediatric outpatients in relation to available guidelines and detected pathogens, 2) to assess antibiotic use on presentation using questionnaires and detection in urine 3) to assess the carriage rates and proportions of resistant intestinal Enterobacteriaceae before, during and after consultation. Materials and methods Patients were prospectively enrolled in Children’s Hospital 1, Ho Chi Minh City, Vietnam and diagnoses, prescribed therapy and outcome were recorded on first visit and on follow-up after 7 days. Respiratory bacterial and viral pathogens were detected using molecular assays. Antibiotic use before presentation was assessed using questionnaires and urine HPLC. The impact of antibiotic usage on intestinal Enterobacteriaceae was assessed with semi-quantitative culture on agar with and without antibiotics on presentation and after 7 and 28 days. Results A total of 563 patients were enrolled between February 2009 and February 2010. Antibiotics were prescribed for all except 2 of 563 patients. The majority were 2 nd and 3 rd generation oral cephalosporins and amoxicillin with or without clavulanic acid. Respiratory viruses were detected in respiratory specimens of 72.5% of patients. Antibiotic use was considered inappropriate in 90.1% and 67.5%, based on guidelines and detected pathogens, respectively. On presentation parents reported antibiotic use for 22% of patients, 41% of parents did not know and 37% denied antibiotic use. Among these three groups, six commonly used antibiotics were detected with HPLC in patients’ urine in 49%, 40% and 14%, respectively. Temporary selection of 3 rd generation cephalosporin resistant intestinal Enterobacteriaceae during antibiotic use was observed, with co-selection of resistance to aminoglycosides and fluoroquinolones. Conclusions We report overuse and overprescription of antibiotics for uncomplicated ARI with selection of resistant intestinal Enterobacteriaceae , posing a risk for community transmission and persistence in a setting of a highly granular healthcare system and unrestricted access to antibiotics through private pharmacies. Registration This study was registered at the International Standard Randomised Controlled Trials Number registry under number ISRCTN32862422: http://www.isrctn.com/ISRCTN32862422

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Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high‐performance liquid chromatography

Toi

Doan

Minh

et al. 2019

Biomedical Chromatography

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In this study, we developed and validated two reliable high‐performance liquid chromatography (HPLC) methods for the qualitative detection of six oral β‐lactams, which are commonly used in pediatric patients with acute respiratory infections (ARIs). Two distinct reverse‐phase chromatographic separations of six β‐lactams were obtained. Four β‐lactams (cefadroxil, cephalexin, cefaclor and cefixime) in urine were separated using a gradient program with a mobile phase consisting of K2HPO4 buffer (20 mm, pH 2.8) and acetonitrile on a LichroCART 250 × 4.6 mm, Purospher STAR C18 end‐capped (5 μm) column. Two remained β‐lactams (amoxicillin and cefuroxime) were analyzed using a gradient elution with the mobile phase containing K2HPO4 buffer (20 mm, pH 3.0) and acetonitrile on a LichroCart® Purospher Star C8 end‐capped column (5 μm, 125 × 4.6 mm). Good linearity within the range of 0.3–30 μg/ml for cefadroxil, cephalexin, cefaclor and cefixime, and 0.2–20 μg/ml for amoxicillin and cefuroxime, was attained. The precisions were <14%. The accuracies ranged from 85.87 to 102.8%. The two validated methods were then applied to determine these six antibiotics in 553 urine samples of pediatric patients with ARIs. As a result, 32.2% were positive with one or more of six tested β‐lactams. Cefixime was the most commonly detected agent, accounting for 9.8% of enrolled patients.

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Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high‐performance liquid chromatography

Cited by 4 publications

References 32 publications

A fast, cost‐saving and sensitive method for determination of cefuroxime in plasma by HPLC with ultraviolet detection

A fast, cost‐saving and sensitive method for determination of cefuroxime in plasma by HPLC with ultraviolet detection

Antibiotic use and prescription and its effects on Enterobacteriaceae in the gut in children with mild respiratory infections in Ho Chi Minh City, Vietnam. A prospective observational outpatient study

Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high‐performance liquid chromatography

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