Variation in paediatric hospital antibiotic guidelines in Europe

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Healthcare Quality Improvement

Background:

• Antibiotic prescribing guidelines are crucial for managing pediatric infections.
• Variability in guideline availability and content can impact patient care and antimicrobial resistance.
• European paediatric hospitals' adherence to standardized treatment protocols is not well-documented.

Purpose of the Study:

• To evaluate the availability, sources, and characteristics of antibiotic prescribing guidelines in European paediatric hospitals.
• To assess guideline content for five common pediatric infection syndromes.
• To identify gaps in current guideline recommendations.

Main Methods:

• An online questionnaire was distributed to 84 hospitals across 19 European countries.
• The survey collected data on the existence and features of antibiotic guidelines.
• Information gathered included empirical antibiotic choices and therapy duration for respiratory tract, urinary tract, skin and soft tissue, osteoarticular infections, and sepsis.

Main Results:

• 74 out of 84 hospitals reported having antibiotic guidelines, but only 20% had complete guidelines for all infection types.
• Urinary tract infection (74%) and neonatal sepsis (71%) had the highest guideline availability.
• Significant variation was observed in recommended antibiotics and duration of therapy, especially for sepsis, with a lack of linkage to local resistance patterns.

Conclusions:

• Comprehensive antibiotic guidelines are generally lacking in European paediatric settings.
• Current guidelines show considerable heterogeneity in antibiotic recommendations and duration of therapy.
• There is a critical need to enhance the quality and evidence base of these guidelines, aligning empirical treatments with antimicrobial resistance data.