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Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study
BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-sus...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591947/ https://www.ncbi.nlm.nih.gov/pubmed/34775956 http://dx.doi.org/10.1186/s12879-021-06860-8 |
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author | Chen, Tian-ming Li, Wen-hui Wang, Fang Tan, Kun Zhu, Qing-xiong Zhou, Kai Liu, Shi-hua Liu, Jing Bi, Jing Deng, Hui-ling Chen, Xue-xia Li, Juan Wang, Yu-min Zhao, Qing Zhu, Liang Ma, Hui-xuan Li, Zhi Deng, Ji-kui Zhu, Chun-hui Wu, Kang-kang Lin, Ai-wei Li, Shuang-jie Wang, Dong-meng Cai, Hui-jun Zhao, Shi-yong Lu, Xu-dong Ye, Lan Dong, Fang Zhang, Wen-shuang Yang, Yong-hong Liu, Gang |
author_facet | Chen, Tian-ming Li, Wen-hui Wang, Fang Tan, Kun Zhu, Qing-xiong Zhou, Kai Liu, Shi-hua Liu, Jing Bi, Jing Deng, Hui-ling Chen, Xue-xia Li, Juan Wang, Yu-min Zhao, Qing Zhu, Liang Ma, Hui-xuan Li, Zhi Deng, Ji-kui Zhu, Chun-hui Wu, Kang-kang Lin, Ai-wei Li, Shuang-jie Wang, Dong-meng Cai, Hui-jun Zhao, Shi-yong Lu, Xu-dong Ye, Lan Dong, Fang Zhang, Wen-shuang Yang, Yong-hong Liu, Gang |
author_sort | Chen, Tian-ming |
collection | PubMed |
description | BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China. METHODS: A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed. RESULTS: 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid. CONCLUSIONS: Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use. |
format | Online Article Text |
id | pubmed-8591947 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85919472021-11-15 Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study Chen, Tian-ming Li, Wen-hui Wang, Fang Tan, Kun Zhu, Qing-xiong Zhou, Kai Liu, Shi-hua Liu, Jing Bi, Jing Deng, Hui-ling Chen, Xue-xia Li, Juan Wang, Yu-min Zhao, Qing Zhu, Liang Ma, Hui-xuan Li, Zhi Deng, Ji-kui Zhu, Chun-hui Wu, Kang-kang Lin, Ai-wei Li, Shuang-jie Wang, Dong-meng Cai, Hui-jun Zhao, Shi-yong Lu, Xu-dong Ye, Lan Dong, Fang Zhang, Wen-shuang Yang, Yong-hong Liu, Gang BMC Infect Dis Research BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China. METHODS: A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed. RESULTS: 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid. CONCLUSIONS: Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use. BioMed Central 2021-11-15 /pmc/articles/PMC8591947/ /pubmed/34775956 http://dx.doi.org/10.1186/s12879-021-06860-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chen, Tian-ming Li, Wen-hui Wang, Fang Tan, Kun Zhu, Qing-xiong Zhou, Kai Liu, Shi-hua Liu, Jing Bi, Jing Deng, Hui-ling Chen, Xue-xia Li, Juan Wang, Yu-min Zhao, Qing Zhu, Liang Ma, Hui-xuan Li, Zhi Deng, Ji-kui Zhu, Chun-hui Wu, Kang-kang Lin, Ai-wei Li, Shuang-jie Wang, Dong-meng Cai, Hui-jun Zhao, Shi-yong Lu, Xu-dong Ye, Lan Dong, Fang Zhang, Wen-shuang Yang, Yong-hong Liu, Gang Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title | Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title_full | Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title_fullStr | Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title_full_unstemmed | Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title_short | Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study |
title_sort | antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in china: a multicenter retrospective study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591947/ https://www.ncbi.nlm.nih.gov/pubmed/34775956 http://dx.doi.org/10.1186/s12879-021-06860-8 |
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