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Children
Special Issues
Diagnostic and Antimicrobial Stewardship in Pediatrics
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Diagnostic and Antimicrobial Stewardship in Pediatrics

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Infectious Diseases".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 4062

Special Issue Editors

Dr. Ulrich von Both

E-Mail Website
Guest Editor
Pediatric Infectious Diseases Unit, Hauner Children’s Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
Interests: diagnostic and antimicrobial stewardship; pediatrics; host response to bacterial pathogens; transcriptomics; tuberculosis; migrant health
Dr. Nikos P. Spyridis

E-Mail Website
Guest Editor
Department of Paediatric Infectious Diseases, Aglaia Kyriakou Children's Hospital, University of Athens, Athens, Greece
Interests: antibiotic use; antibiotis stewardship program; paediatrics; hospital acquired infection; pharmakokinetics; pharmakodynamics; antibiotic resistance; neonatal infections; infections in the immunocompromised

Special Issue Information

Dear Colleagues,

Children with fever and signs of infection present to local private practices or children’s hospital A&E every day. In most cases, these children are not suffering from a serious bacterial infection. Still, due to lack of better diagnostics, many of these children receive antibiotics. In view of the fact that antimicrobial resistance (AMR) has been defined by the WHO as one of ten major threats to global health, and bearing in mind the extensive antibiotic use in pediatric settings, the restriction and rational use of antimicrobials is urgently needed. Research efforts striving for better diagnostic tests to differentiate bacterial from non-bacterial causes of fever will play a key role in helping pediatricians in their decision process for or against the prescription of an antimicrobial. Efforts tailored to implement antibiomicrobial stewardship programs (ASPs) in the hospital as well as the outpatient setting are equally important. These programs may start by addressing individual aspects of antibiotic prescribing or as more complex bundle approaches.

This Special Issue intends to provide a forum to present and discuss relevant advances in the field of diagnostic and antibiotic stewardship in both the hospital-based and outpatient setting. We cordially invite investigators to contribute original research articles or comprehensive reviews that will stimulate the scientific community to identify new and innovative strategies to reduce unnecessary antimicrobial use and improve the clinical care of our patients.

We look forward to hearing from you regarding your potential contribution.

Dr. Ulrich von Both
Dr. Nikos P. Spyridis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotics
  • antimicrobial
  • pediatrics
  • antimicrobial consumption
  • choose wisely
  • diagnostic tests
  • point-of-care tests

Published Papers (2 papers)

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Research

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15 pages, 3207 KiB  
Article
Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
by Elena Fresán-Ruiz, Ana Carolina Izurieta-Pacheco, Mònica Girona-Alarcón, Juan Carlos de Carlos-Vicente, Amaya Bustinza-Arriortua, María Slocker-Barrio, Sylvia Belda-Hofheinz, Montserrat Nieto-Moro, Sonia María Uriona-Tuma, Laia Pinós-Tella, Elvira Morteruel-Arizcuren, Cristina Schuffelmann, Yolanda Peña-López, Sara Bobillo-Pérez, Iolanda Jordan and on behalf of the Pediatric-ENVIN-HELICS Study Group
Children 2022, 9(6), 902; https://doi.org/10.3390/children9060902 - 16 Jun 2022
Cited by 3 | Viewed by 1909
Abstract
Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over [...] Read more.
Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over a 3-month period each year (1 April–30 June) from 2014–2019. To make comparisons and evaluate the influence of AMS programs on antibiotic use in PICUs, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once 84% of the units had incorporated an AMS program). A total of 11,260 pediatric patients were included. Total antibiotic prescriptions numbered 15,448 and, overall, 8354 patients (74.2%) received at least one antibiotic. Comparing the two periods, an increase was detected in the number of days without antibiotics in patients who received them divided by the number of days in PICUs, for community-acquired infections (p < 0.001) and healthcare-associated infections (HAIs) acquired in PICUs (p < 0.001). Antibiotics were empirical in 7720 infections (85.6%), with an increase in appropriate antibiotic indications during the second period (p < 0.001). The main indication for antibiotic adjustment was de-escalation, increasing in the second period (p = 0.045). Despite the high rate of antibiotic use in PICUs, our results showed a significant increase in appropriate antibiotic use and adjustment following the implementation of AMS programs. Full article
(This article belongs to the Special Issue Diagnostic and Antimicrobial Stewardship in Pediatrics)
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19 pages, 793 KiB  
Systematic Review
Diagnostic Stewardship—The Impact of Rapid Diagnostic Testing for Paediatric Respiratory Presentations in the Emergency Setting: A Systematic Review
by Keshani Weragama, Poonam Mudgil and John Whitehall
Children 2022, 9(8), 1226; https://doi.org/10.3390/children9081226 - 13 Aug 2022
Cited by 2 | Viewed by 1677
Abstract
Antimicrobial resistance is a growing public health crisis, propelled by inappropriate antibiotic prescription, in particular the over-prescription of antibiotics, prolonged duration of antibiotic therapy and the overuse of broad-spectrum antibiotics. The paediatric population, in particular, those presenting to emergency settings with respiratory symptoms, [...] Read more.
Antimicrobial resistance is a growing public health crisis, propelled by inappropriate antibiotic prescription, in particular the over-prescription of antibiotics, prolonged duration of antibiotic therapy and the overuse of broad-spectrum antibiotics. The paediatric population, in particular, those presenting to emergency settings with respiratory symptoms, have been associated with a high rate of antibiotic prescription rates. Further research has now shown that many of these antibiotic prescriptions may have been avoided, with more targeted diagnostic methods to identify underlying aetiologies. The purpose of this systematic review was to assess the impact of rapid diagnostic testing, for paediatric respiratory presentations in the emergency setting, on antibiotic prescription rates. To review the relevant history, a comprehensive search of Medline, EMBASE and Cochrane Database of Systematic Reviews was performed. Eighteen studies were included in the review, and these studies assessed a variety of rapid diagnostic testing tools and outcome measures. Overall, rapid diagnostic testing was found to be an effective method of diagnostic antibiotic stewardship with great promise in improving antibiotic prescribing behaviours. Further studies are required to evaluate the use of rapid diagnostic testing with other methods of antibiotics stewardship, including clinical decisions aids and to increase the specificity of interventions following diagnosis to further reduce rates of antibiotic prescription. Full article
(This article belongs to the Special Issue Diagnostic and Antimicrobial Stewardship in Pediatrics)
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