Related Experiment Videos
No Prophylactic Antibiotic Use for Young Children's Intussusception with Low-risk Infection after Successful Air
Yuan Zhang1,2, Wen Zou3, Lemeng Ren4
1Center of Evidence-based Medicine, Second Hospital of Shandong University, Jinan, China.
Insights
Prophylactic antibiotics offer little benefit for young children with low-risk intussusception after air enema reduction. China's national policy has improved antibiotic use, but longer hospital stays were observed in children receiving antibiotics.
Area of Science:
- Pediatric Gastroenterology
- Infectious Disease Management
- Public Health Policy
Background:
- Antibiotic stewardship is crucial, especially in pediatric intussusception cases.
- Prophylactic antibiotic use post-air enema reduction in children lacks robust clinical data.
- Chinese national policy since 2011 aims to regulate antibacterial drug use.
Purpose of the Study:
- To evaluate the clinical value of prophylactic antibiotics in young children with intussusception after successful air enema reduction.
- To assess the impact of China's national antibiotic policy on clinical practice.
- To compare outcomes between children receiving and not receiving prophylactic antibiotics.
Main Methods:
- Retrospective, non-randomized comparative study.
- Inclusion of 188 young children with intussusception treated between 2011-2013.
- Comparison of outcomes between 51 children receiving prophylactic antibiotics and 137 not receiving them.
Main Results:
- No significant differences in demographics, clinical parameters, or complications between the groups.
- National policy significantly improved antibiotic use for low-risk intussusception (OR < 0.001, P < 0.001).
- Children receiving prophylactic antibiotics had longer inpatient stays (median 27.0 hours vs 21.0 hours, P = 0.003).
Conclusions:
- Prophylactic antibiotics appear to have minimal clinical value in low-risk pediatric intussusception post-air enema reduction.
- Policy interventions are effective in optimizing antibiotic prescribing in China.
- Further research may refine antibiotic guidelines for pediatric intussusception.
Abstract:
The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.