Related Experiment Video

Updated: Oct 1, 2026

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

Factors associated with increased risk in inappropriate empiric antibiotic treatment of childhood bacteraemia

S Ashkenazi1, Z Samra, H Konisberger

  • 1Department of Paediatrics, Schneider Children's Medical Centre, Petah Tiqva, Israel.

European Journal of Pediatrics
|July 1, 1996
PubMed

Insights

Inappropriate antibiotic therapy affects 38% of children with bloodstream infections, increasing mortality. Risk factors include age, hospital-acquired infections, and central IV lines, highlighting the need for improved treatment strategies.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Clinical Microbiology

Background:

  • Bacteraemia in children poses a significant risk for adverse outcomes.
  • Empiric antibiotic therapy is crucial but can be inappropriate.
  • Identifying at-risk populations is essential for optimizing treatment.

Purpose of the Study:

  • To identify risk factors for inappropriate empiric antibiotic therapy in bacteraemic children.
  • To analyze the association between inappropriate therapy and mortality.
  • To inform strategies for improving antibiotic use in pediatric infections.

Main Methods:

  • Prospective study of 516 bacteraemic episodes in children.
  • Univariate and multivariate analyses to identify risk factors.
  • Logistic regression to determine independent predictors of inappropriate therapy.

Main Results:

  • Inappropriate empiric antibiotic therapy occurred in 38% of episodes and was linked to higher mortality.
  • Higher rates of inappropriate therapy were observed in children aged 1-5 years (51%), hospital-acquired bacteraemia, cytotoxic therapy, and central IV line use.
  • Treatment appropriateness varied significantly by the source of bacteraemia, underlying conditions, and causative microorganisms.

Conclusions:

  • Specific clinical variables independently predict the risk of inappropriate antibiotic treatment in bacteraemic children.
  • Targeted interventions are necessary for high-risk pediatric patients to improve outcomes.
  • Enhanced antimicrobial stewardship is crucial for reducing inappropriate empiric antibiotic use.
Abstract

More Related Videos

Atomic Force Microscopy Combined with Infrared Spectroscopy as a Tool to Probe Single Bacterium Chemistry08:51

Atomic Force Microscopy Combined with Infrared Spectroscopy as a Tool to Probe Single Bacterium Chemistry

Published on: September 15, 2020

Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes08:58

Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes

Published on: March 3, 2023

Related Concept Videos

Antibiotic Selection01:45

Antibiotic Selection

Researchers use antibiotic resistance genes to identify bacteria that possess a plasmid containing their gene of interest. Antibiotic resistance naturally occurs when a spontaneous DNA mutation creates changes in bacterial genes that eliminate antibiotic activity. Bacteria can share these new resistance genes with their offspring and other bacteria. The overuse and misuse of antibiotics have created a public health crisis, as resistant and multi-resistant bacteria continue to develop.Antibiotic...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Development of Antibiotic Resistance01:30

Development of Antibiotic Resistance

Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...
Microbiota Modulation by Antibiotics01:21

Microbiota Modulation by Antibiotics

Antibiotics have revolutionized modern medicine by saving countless lives from bacterial infections. However, their widespread use has inadvertently harmed the delicate balance of the human gut microbiota. The gut microbiota, a complex community of bacteria, archaea, viruses, and fungi, plays a vital role in regulating metabolism, immune responses, and maintaining intestinal health. Antibiotics, especially broad-spectrum types, disrupt this ecosystem by eradicating both harmful and beneficial...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...