Abstract:
BACKGROUND:The clinical and economic outcomes associated with pediatric antimicrobial stewardship programs (ASPs) and other supplemental antimicrobial stewardship (AS) interventions have not been well described or reviewed. METHODS:We performed a systematic review using PubMed to identify studies with any of the following terms in the title or abstract: "antimicrobial stewardship," "antimicrobial control," "antibiotic control," or "antibiotic stewardship." Studies were further limited to inpatient studies in the United States that contained the terms: "child," "children," "pediatric*" ("*" includes all terms with the same stem), "paediatric,*" "newborn," "infant," or "neonat,*" in the title or abstract. Clinical and economic outcomes from each relevant study were summarized. RESULTS:Nine original studies reported outcomes related to formal pediatric ASPs. An additional 8 studies focused on specific AS interventions; 3 on management of community-acquired pneumonia, 2 on vancomycin-specific initiatives, and 1 each on clinical support, antibiotic restriction, and antibiotic rotation. Reported outcomes include decreases in antimicrobial utilization (11 studies), prescribing errors (3 studies), and drug costs (3 studies). Five studies assessed the potential adverse effects of AS interventions on patient safety and found none. Data to support an association between pediatric AS interventions and antimicrobial resistance are limited. CONCLUSIONS:A small number of pediatric studies evaluating ASPs or other AS strategies have been published. These studies demonstrate reductions in antimicrobial utilization, cost, and prescribing errors with no apparent negative impact on patient safety. Although the studies are promising, the current evidence base is limited. Additional studies focusing on the appropriateness and outcomes of antimicrobial prescribing practices as well as more formalized economic evaluations are needed.
journal_name
J Pediatric Infect Dis Socjournal_title
Journal of the Pediatric Infectious Diseases Societyauthors
Smith MJ,Gerber JS,Hersh ALdoi
10.1093/jpids/piu141subject
Has Abstractpub_date
2015-12-01 00:00:00pages
e127-35issue
4eissn
2048-7193issn
2048-7207pii
piu141journal_volume
4pub_type
杂志文章,评审abstract:BACKGROUND:Studies describing the activity of imipenem/relebactam against gram-negative bacilli (GNB) isolated from pediatric patients are lacking in the peer-reviewed literature. We address this deficiency by reporting on GNB tested against imipenem/relebactam as part of the Study for Monitoring Antimicrobial Resistan...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piaa056
更新日期:2020-06-14 00:00:00
abstract:BACKGROUND:As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)-infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resource-limited settings....
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pit024
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Acute gastroenteritis (AGE) in hematopoietic cell transplant (HCT) patients causes significant morbidity and mortality. Data regarding the longitudinal assessment of infectious pathogens during symptomatic AGE and asymptomatic periods, particularly in children, are limited. We investigated the prevalence of ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz063
更新日期:2020-09-17 00:00:00
abstract:Background:Trichosporonosis is an emerging and often fatal opportunistic fungal infection in immunocompromised patients, particularly those with hematologic malignancy, but data in children are lacking. Methods:We report here 3 cases of invasive infection caused by Trichosporon asahii in pediatric patients with acute ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章,评审
doi:10.1093/jpids/pix031
更新日期:2018-08-17 00:00:00
abstract:BACKGROUND:This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates. METHODS:We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabili...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pit044
更新日期:2014-03-01 00:00:00
abstract::We conducted a survey of pediatric members of the Emerging Infections Network regarding outpatient parenteral antimicrobial therapy (OPAT) practices and clinical decision making about OPAT initiation. We identified substantial variation in characteristics and resources of pediatric OPAT practices. Opportunities to imp...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pis137
更新日期:2014-03-01 00:00:00
abstract::We performed a seroepidemiologic study of sera from children in Brooklyn, New York, before and after the implementation of prenatal chlamydial screening almost 20% of children aged ≤10 years in the prescreening group had anti-Chlamydia trachomatis immunoglobulin G compared with none in the postscreening group. ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piaa002
更新日期:2020-01-20 00:00:00
abstract:Background:Lower procalcitonin (PCT) concentrations are associated with reduced risk of bacterial community-acquired pneumonia (CAP) in adults, but data in children are limited. Methods:We analyzed serum PCT concentrations from children hospitalized with radiographically confirmed CAP enrolled in the Centers for Disea...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piw091
更新日期:2018-02-19 00:00:00
abstract:Background:Children undergoing CIC frequently have positive urine culture results and receive many antimicrobial agents. Subsequently, this population is at high risk for infections caused by antimicrobial-resistant bacteria. Resistant pathogens, such as vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Ent...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piw056
更新日期:2017-11-24 00:00:00
abstract::We report a case of disseminated tularemia in a previously healthy 8-month-old male. This case highlights an atypical presentation of tularemia with multisystem organ involvement. The diagnosis was complicated by concurrent primary cytomegalovirus infection. Bronchoalveolar lavage culture confirmed the diagnosis. The ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piaa066
更新日期:2020-06-14 00:00:00
abstract:Background:Evaluation for neonatal sepsis routinely includes performing both aerobic and anaerobic blood cultures despite our lack of knowledge of the true incidence of anaerobic bacteremia in this age group and the consequences of not performing these paired cultures. Methods:We performed a retrospective review of al...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pix088
更新日期:2018-08-17 00:00:00
abstract:BACKGROUND:Despite a high burden of staphylococcal skin disease in children and high incidence of Staphylococcus aureus bacteremia in adult Indigenous populations in northern Australia, there are few studies describing incidence or clinical information of invasive S aureus (ISA) infections in children. METHODS:We cond...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piu013
更新日期:2014-12-01 00:00:00
abstract::We examined the uptake of rotavirus vaccine and compared trends in acute gastroenteritis (AGE)-associated hospitalizations and outpatient visits among American Indian and Alaska Native (AI/AN) children aged <5 years before and after introduction of the rotavirus vaccine. The rates of AGE-associated hospitalization and...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pix098
更新日期:2018-05-15 00:00:00
abstract:Introduction:Antimicrobial use is decreasing across freestanding children's hospitals, predominantly in institutions with antimicrobial stewardship programs (ASPs) in place. A highly effective ASP should effect a greater decrease in use than predicted by existing trends. Antimicrobial stewardship programs depend on cli...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piw054
更新日期:2017-11-24 00:00:00
abstract::Pneumonia, most often caused by a respiratory virus, is common in childhood. Mycoplasma pneumoniae also is detected frequently, particularly in older children in the era of pneumococcal conjugate vaccination. Despite recommendations for β-lactam antibiotics, macrolide antibiotics, including erythromycin, clarithromyci...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章,评审
doi:10.1093/jpids/pix083
更新日期:2018-02-19 00:00:00
abstract:BACKGROUND:Children who develop malaria after returning to a setting in which the disease is not endemic are at high risk for critical delays in diagnosis and initiation of antimalarial therapy. We assessed the clinical impact of the implementation of malaria rapid diagnostic testing (RDT) on the management of children...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz022
更新日期:2020-07-13 00:00:00
abstract::Among 66 antiretroviral-naive children aged <3 years with human immunodeficiency virus (HIV) or coinfected with HIV and tuberculosis and initiating efavirenz-based antiretroviral therapy (ART), non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance was detected before ART in 5 (7.6%). Virologic failure occu...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz038
更新日期:2020-04-30 00:00:00
abstract:Background:Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United St...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piw064
更新日期:2017-11-24 00:00:00
abstract::Children presenting to an emergency department following an animal bite were found to be at risk for infection if they had puncture wounds, crush wounds, or were bitten by a cat. Of the infected wounds that were cultured, methicillin-resistant Staphylococcus aureus was not isolated as a pathogen. ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pis096
更新日期:2013-12-01 00:00:00
abstract::The reduction in human immunodeficiency virus (HIV) transmission through breastmilk with maternal combination antiretroviral therapy (cART) has led many pregnant women living with HIV and healthcare providers to question exclusive formula feeding in resource-rich settings. Here, we describe cART prophylaxis in 3 breas...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz003
更新日期:2020-04-30 00:00:00
abstract:BACKGROUND:Parechovirus A (PeV-A) is an important cause of sepsis and meningoencephalitis in neonates and young infants. Thus, identifying the source of PeV-A is essential for prevention; however, little is known regarding the spread of PeV-A among family members of PeV-A-infected neonates and young infants. METHODS:I...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piy079
更新日期:2019-12-27 00:00:00
abstract::Little information on the efficacy and pharmacokinetics of letermovir among immunocompromised children is currently available. We describe here the use of letermovir in a 2-year-old immunocompromised child with ganciclovir-resistant cytomegalovirus disease who required extracorporeal membrane oxygenation. Detailed inf...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz033
更新日期:2020-02-28 00:00:00
abstract::We report here 18 cases of pediatric group A streptococcal toxic shock syndrome, associated clinical findings, and bacterial molecular genetic characteristics discovered through whole-genome sequencing. This comparative whole-genome sequencing revealed unique gene content (speK) and polymorphisms (dpiB) in emm87 group...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piy069
更新日期:2019-07-01 00:00:00
abstract::Recent guidelines recommend empiric vancomycin dosing of 60 mg/kg per day and consideration of higher trough concentrations (15-20 mcg/mL) in children with invasive infections. In this study, we report a retrospective review evaluating the dose/trough relationship and predicted area under the curve in pediatric patien...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pis083
更新日期:2013-09-01 00:00:00
abstract::Children with healthcare-associated Clostridium difficile infection were identified. The incidence increased from 3.2/10,000 patient days in 2007 to 5.2/10,000 patient days in 2011 (p < 0.001). Of 169 isolates, the most common North American Pulsed-Field (NAP) types were NAP4 (n = 43; (25.4%), and NAP1 (n = 25;14.8%) ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piv011
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Scrub typhus, caused by Orientia tsutsugamushi, is a major cause of acute febrile illness in children in the rural tropics. METHODS:We recruited 60 febrile pediatric patients with a positive scrub typhus rapid diagnostic test result and 40 healthy controls from Chiang Rai Province in northern Thailand. Diag...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz014
更新日期:2020-04-30 00:00:00
abstract::Coronaviruses contribute to the burden of respiratory diseases in children, frequently manifesting in upper respiratory symptoms considered to be part of the "common cold." Recent epidemics of novel coronaviruses recognized in the 21st century have highlighted issues of zoonotic origins of transmissible respiratory vi...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章,评审
doi:10.1093/jpids/piaa037
更新日期:2020-04-30 00:00:00
abstract::Although cryptococcal meningitis is uncommon in children and rare in neonates, it does occur. We highlight circumstances in which the diagnosis should be considered and methods required to confirm the diagnosis in young patients. ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/pis037
更新日期:2012-09-01 00:00:00
abstract::E-consults replace "curbside" interactions, facilitate provider-specialist communication, document within the medical record, and track relative value units (RVUs). Pediatric infectious diseases (PID) E-consults commonly relate to vaccines, exposures, diagnoses, and treatments. The documented RVU effort of 197 consecu...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piaa041
更新日期:2020-05-05 00:00:00
abstract:BACKGROUND:Our goal was to characterize the epidemiology and clinical significance of congenital Zika virus (ZIKV) exposure by prospectively following a cohort of infants with possible congenital exposure through their first year of life. METHODS:We included infants born in New York City between 2016 and 2017 who had ...
journal_title:Journal of the Pediatric Infectious Diseases Society
pub_type: 杂志文章
doi:10.1093/jpids/piz027
更新日期:2020-07-13 00:00:00