Related Experiment Video

Updated: Dec 8, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

13.2K

Trends in Use of Postdischarge Intravenous Antibiotic Therapy for Children

Michael E Fenster1, Adam L Hersh1, Rajendu Srivastava1,2

  • 1Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.

Journal of Hospital Medicine
|September 23, 2020
PubMed

Insights

Postdischarge intravenous antibiotics (PD-IV) for pediatric appendicitis, osteomyelitis, and pneumonia have significantly decreased since 2000. While PD-IV use has declined, variations in hospital practices persist, indicating a need for further standardization in pediatric antibiotic care.

Area of Science:

  • Pediatric Infectious Diseases
  • Antibiotic Stewardship
  • Healthcare Quality Improvement

Background:

  • Postdischarge intravenous antibiotics (PD-IV) via peripherally inserted central catheters (PICCs) were common for complicated pediatric infections.
  • Recent evidence suggests PD-IV offers no advantage over oral therapy and may increase complications.
  • The trend in PD-IV utilization for specific pediatric conditions remains unclear.

Purpose of the Study:

  • To analyze trends in PD-IV use for complicated appendicitis, osteomyelitis, and pneumonia in children from 2000 to 2018.
  • To identify changes in PD-IV prescribing patterns over time.
  • To assess hospital-level variations in PD-IV use.

Main Methods:

  • Utilized a national children's hospital database.
  • Retrospectively analyzed PD-IV utilization data for pediatric patients diagnosed with complicated appendicitis, osteomyelitis, or complicated pneumonia.
  • Calculated risk ratios (RR) and 95% confidence intervals (CI) to assess changes in PD-IV use.

Main Results:

  • PD-IV use decreased significantly across all three conditions: complicated appendicitis (13% to 2%, RR 0.15), osteomyelitis (61% to 22%, RR 0.41), and complicated pneumonia (29% to 19%, RR 0.63).
  • Despite overall reductions, considerable variation in PD-IV use among hospitals was observed in 2018.
  • The decline in PD-IV use suggests a shift towards more conservative antibiotic management strategies.

Conclusions:

  • There has been a substantial decrease in the use of PD-IV for complicated pediatric appendicitis, osteomyelitis, and pneumonia between 2000 and 2018.
  • Hospital-level variability in PD-IV prescribing persists, highlighting opportunities for practice standardization and guideline implementation.
  • Further research may be warranted to optimize antibiotic strategies and ensure equitable care for children with these infections.

More Related Videos

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

30.9K
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit09:57

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

Published on: July 13, 2019

13.5K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
131
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
134
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
178
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to...
109
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
107
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
126