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Capsular Serotyping of Streptococcus pneumoniae Using the Quellung Reaction
04:25

Capsular Serotyping of Streptococcus pneumoniae Using the Quellung Reaction

Published on: February 24, 2014

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Effects of Delayed Antibiotic Therapy on Outcomes in Children with Streptococcus pneumoniae Sepsis

Qinyuan Li1,2, Jie Cheng1,2, Yi Wu1,2

  • 1Key Laboratory of Pediatrics in Chongqing, Chongqing, China.

Antimicrobial Agents and Chemotherapy
|July 3, 2019
PubMed

Insights

Timely antibiotic administration is crucial for children with Streptococcus pneumoniae sepsis. Delays beyond 13.6 hours significantly increase risks of mortality, septic shock, and mechanical ventilation, highlighting the need for prompt treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Delayed antimicrobial therapy in sepsis is linked to adverse patient outcomes.
  • The optimal timing for antibiotic administration in pediatric sepsis, particularly for Streptococcus pneumoniae infections, requires further clarification.

Purpose of the Study:

  • To investigate the impact of antimicrobial administration timing on outcomes in pediatric sepsis.
  • To determine an optimal empirical antibiotic administration time window for children diagnosed with Streptococcus pneumoniae sepsis.

Main Methods:

  • A retrospective study was conducted involving pediatric patients with Streptococcus pneumoniae sepsis between May 2011 and December 2018.
  • Classification and Regression Tree (CART) analysis identified the time-to-appropriate-therapy (TTAT) breakpoint.
  • Outcomes were compared between early and delayed therapy groups based on the CART-derived TTAT breakpoint.

Main Results:

  • The CART analysis established a TTAT breakpoint of 13.6 hours.
  • A TTAT of ≥13.6 hours was an independent predictor of increased in-hospital mortality (OR=39.26), septic shock (OR=4.58), and need for mechanical ventilation (OR=2.70).
  • Higher Pediatric Risk of Mortality (PRISM) III scores (≥10) were associated with delayed antibiotic therapy.

Conclusions:

  • Delayed antibiotic therapy in pediatric Streptococcus pneumoniae sepsis is associated with significantly poorer outcomes.
  • The optimal empirical antibiotic administration time window for children with Streptococcus pneumoniae sepsis is within 13.6 hours.
  • Clinical efforts should focus on ensuring prompt and appropriate antimicrobial administration to improve patient outcomes.

Keywords:
Streptococcus pneumoniaechildrendelayed therapysepsistime to appropriate therapy

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