Related Experiment Video
Updated: Jun 29, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing,
Kevin Meesters1,2, Danilo Buonsenso3,4
1Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
Abstract:
Antibiotic overprescribing is prevalent in pediatric emergency medicine, influenced by clinician-caregiver dynamics and diagnostic uncertainties, and poses substantial risks such as increasing antibacterial resistance, adverse drug reactions, and increased healthcare expenditures. While antimicrobial stewardship programs have proven effective in optimizing antibiotic use within inpatient healthcare settings, their implementation in pediatric emergency medicine presents specific challenges. Existing biomarkers like white blood cell count, C-reactive protein, procalcitonin, and presepsin have limitations in their ability to distinguish (serious) bacterial infections from other etiologies of fever. Furthermore, rapid antigen detection tests and guidelines aimed at guiding antibiotic prescriptions for children have not consistently reduced unnecessary antibiotic use. To improve antibiotic prescribing practices, potential strategies include the utilization of decision support tools, audit and feedback, establishing follow-up procedures, implementing safety netting systems, and delivering comprehensive training and supervision. Notably, host genome signatures have also gained attention for their potential to facilitate rapid and precise diagnoses of inflammatory syndromes. Standardized metrics are crucial for evaluating antimicrobial use within pediatric healthcare settings, enabling the establishment of benchmarks for assessing antibiotic utilization, quality enhancement initiatives, and research endeavors.
Insights
Pediatric antibiotic overprescribing is common, leading to resistance and higher costs. New strategies and biomarkers are needed to improve antibiotic use in children
Area of Science:
- Pediatric Emergency Medicine
- Antimicrobial Stewardship
- Biomarkers in Infectious Diseases
Background:
- Antibiotic overprescribing is a significant issue in pediatric emergency medicine, driven by diagnostic uncertainty and clinician-caregiver interactions.
- This practice contributes to rising antimicrobial resistance, adverse drug reactions, and increased healthcare costs.
- Current biomarkers and diagnostic tests have limitations in accurately identifying bacterial infections in children.
Purpose of the Study:
- To review the challenges and potential strategies for optimizing antibiotic prescribing in pediatric emergency settings.
- To explore the limitations of existing diagnostic tools and biomarkers.
- To highlight the need for improved methods for diagnosing infections and evaluating antimicrobial use.
Main Methods:
- Literature review of antibiotic prescribing practices in pediatric emergency medicine.
- Analysis of current biomarkers (e.g., procalcitonin, presepsin) and diagnostic tests.
- Exploration of novel approaches, including host genome signatures and decision support tools.
Main Results:
- Existing biomarkers and rapid tests have not consistently reduced unnecessary antibiotic prescriptions.
- Implementation of antimicrobial stewardship programs faces unique challenges in the emergency setting.
- Decision support tools, audit and feedback, and enhanced training are potential strategies for improvement.
Conclusions:
- Optimizing antibiotic use in pediatric emergency medicine requires a multi-faceted approach.
- Further research into novel biomarkers and diagnostic strategies, like host genome signatures, is warranted.
- Standardized metrics are essential for evaluating and improving antimicrobial utilization in pediatric care.
More Related Videos
08:58Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
03:22Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE
Published on: March 1, 2024
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
00:57Antibiotic Selection
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:23Antimicrobial Proteins
Interferons
Interferons (IFNs) are proteins produced by lymphocytes, macrophages, and fibroblasts infected with viruses. While IFNs cannot prevent viruses from entering and...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:02Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...