Cargando…
Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review
Bronchiolitis is a common lower respiratory tract illness in young children often caused by the respiratory syncytial virus (RSV). Antimicrobials are not recommended in infants with bronchiolitis unless there is strong evidence that a bacterial coinfection exists. METHODS: We conducted a retrospecti...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831042/ https://www.ncbi.nlm.nih.gov/pubmed/31745514 http://dx.doi.org/10.1097/pq9.0000000000000211 |
_version_ | 1783465878062366720 |
---|---|
author | Kalil, Jennifer Bowes, Jennifer Reddy, Deepti Barrowman, Nick Le Saux, Nicole |
author_facet | Kalil, Jennifer Bowes, Jennifer Reddy, Deepti Barrowman, Nick Le Saux, Nicole |
author_sort | Kalil, Jennifer |
collection | PubMed |
description | Bronchiolitis is a common lower respiratory tract illness in young children often caused by the respiratory syncytial virus (RSV). Antimicrobials are not recommended in infants with bronchiolitis unless there is strong evidence that a bacterial coinfection exists. METHODS: We conducted a retrospective chart review comparing antimicrobial use and outcomes in previously healthy infants ≤24 months of age with RSV bronchiolitis at a single Canadian tertiary pediatric hospital during RSV seasons (December–April) from 2011 to 2016. An audit and feedback antimicrobial stewardship program was introduced in this hospital in August 2014. RESULTS: Compared with the 2011–2012 cohort, the 2015–2016 cohort showed a decrease of 46% in mean days of therapy per 1,000 patient-days in the >28 days old age group of patients. There was also a 15.1% absolute reduction in the proportion of patients who received any antimicrobials in the hospital between the 2 cohorts (neonates included). The proportion of patients receiving antimicrobial prescriptions at discharge also decreased from 33.5% to 19%. The use of second-generation cephalosporins was eliminated in the 2016 cohort. There was a significant decrease in length of stay between the 2011–2012 and 2015–2016 cohorts, and no readmissions were documented. CONCLUSIONS: This study adds to the accumulating literature that antimicrobial stewardship program interventions along with guidelines and order sets can safely contribute to a reduction in antimicrobial use both in hospital and at discharge in children <2 years of age hospitalized due to RSV. Further research in identifying those who would or would not benefit from antibiotics should be promoted. |
format | Online Article Text |
id | pubmed-6831042 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-68310422019-11-19 Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review Kalil, Jennifer Bowes, Jennifer Reddy, Deepti Barrowman, Nick Le Saux, Nicole Pediatr Qual Saf Individual QI projects from single institutions Bronchiolitis is a common lower respiratory tract illness in young children often caused by the respiratory syncytial virus (RSV). Antimicrobials are not recommended in infants with bronchiolitis unless there is strong evidence that a bacterial coinfection exists. METHODS: We conducted a retrospective chart review comparing antimicrobial use and outcomes in previously healthy infants ≤24 months of age with RSV bronchiolitis at a single Canadian tertiary pediatric hospital during RSV seasons (December–April) from 2011 to 2016. An audit and feedback antimicrobial stewardship program was introduced in this hospital in August 2014. RESULTS: Compared with the 2011–2012 cohort, the 2015–2016 cohort showed a decrease of 46% in mean days of therapy per 1,000 patient-days in the >28 days old age group of patients. There was also a 15.1% absolute reduction in the proportion of patients who received any antimicrobials in the hospital between the 2 cohorts (neonates included). The proportion of patients receiving antimicrobial prescriptions at discharge also decreased from 33.5% to 19%. The use of second-generation cephalosporins was eliminated in the 2016 cohort. There was a significant decrease in length of stay between the 2011–2012 and 2015–2016 cohorts, and no readmissions were documented. CONCLUSIONS: This study adds to the accumulating literature that antimicrobial stewardship program interventions along with guidelines and order sets can safely contribute to a reduction in antimicrobial use both in hospital and at discharge in children <2 years of age hospitalized due to RSV. Further research in identifying those who would or would not benefit from antibiotics should be promoted. Wolters Kluwer Health 2019-08-30 /pmc/articles/PMC6831042/ /pubmed/31745514 http://dx.doi.org/10.1097/pq9.0000000000000211 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Individual QI projects from single institutions Kalil, Jennifer Bowes, Jennifer Reddy, Deepti Barrowman, Nick Le Saux, Nicole Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title | Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title_full | Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title_fullStr | Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title_full_unstemmed | Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title_short | Pediatric Inpatient Antimicrobial Stewardship Program Safely Reduces Antibiotic Use in Patients with Bronchiolitis Caused by Respiratory Syncytial Virus: A Retrospective Chart Review |
title_sort | pediatric inpatient antimicrobial stewardship program safely reduces antibiotic use in patients with bronchiolitis caused by respiratory syncytial virus: a retrospective chart review |
topic | Individual QI projects from single institutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831042/ https://www.ncbi.nlm.nih.gov/pubmed/31745514 http://dx.doi.org/10.1097/pq9.0000000000000211 |
work_keys_str_mv | AT kaliljennifer pediatricinpatientantimicrobialstewardshipprogramsafelyreducesantibioticuseinpatientswithbronchiolitiscausedbyrespiratorysyncytialvirusaretrospectivechartreview AT bowesjennifer pediatricinpatientantimicrobialstewardshipprogramsafelyreducesantibioticuseinpatientswithbronchiolitiscausedbyrespiratorysyncytialvirusaretrospectivechartreview AT reddydeepti pediatricinpatientantimicrobialstewardshipprogramsafelyreducesantibioticuseinpatientswithbronchiolitiscausedbyrespiratorysyncytialvirusaretrospectivechartreview AT barrowmannick pediatricinpatientantimicrobialstewardshipprogramsafelyreducesantibioticuseinpatientswithbronchiolitiscausedbyrespiratorysyncytialvirusaretrospectivechartreview AT lesauxnicole pediatricinpatientantimicrobialstewardshipprogramsafelyreducesantibioticuseinpatientswithbronchiolitiscausedbyrespiratorysyncytialvirusaretrospectivechartreview |