Effect of a quality improvement intervention to decrease delays in antibiotic delivery in pediatric febrile...

Area of Science:

• Pediatric critical care medicine
• Oncology
• Infectious diseases

Background:

• Severe sepsis guidelines recommend antibiotics within 1 hour.
• Febrile neutropenia in pediatric oncology patients requires prompt antibiotic treatment.
• Timely antibiotic delivery is crucial for managing severe infections in immunocompromised children.

Purpose of the Study:

• To evaluate if pre-positioned antibiotics in emergency carts reduce time to administration.
• To assess the impact of this intervention on medical complications in pediatric oncology patients with febrile neutropenia.

Main Methods:

• A before-and-after observational study design was used.
• The study included pediatric patients (age ≤18) in the ICU with chemotherapy-induced febrile neutropenia.
• Antibiotic delivery times were retrospectively collected from 25 patient charts for each period.

Main Results:

• Median time to antibiotic delivery decreased from 164 to 55 minutes post-intervention.
• The percentage of patients receiving antibiotics within 60 minutes increased from 0% to 52% (P < .001).
• Complication rates remained low in both pre- and post-intervention periods.

Conclusions:

• A simple quality improvement intervention effectively reduced antibiotic administration time.
• This intervention supports guideline adherence for early antibiotic use in pediatric ICU patients.
• Pre-positioning antibiotics is a feasible strategy to improve sepsis care in vulnerable pediatric populations.