Antibiotic use in children hospitalised for influenza, 2010-2021: the Canadian Immunization Monitoring Program Active (IMPACT)

被引：1

作者：

Schober, Tilmann ^{[1
,2
]}

Morris, Shaun K. ^{[3
]}

Bettinger, Julie A. ^{[4
,5
]}

Burton, Catherine ^{[6
]}

Halperin, Scott A. ^{[7
]}

Jadavji, Taj ^{[8
]}

Kazmi, Kescha ^{[3
]}

Modler, Jacqueline ^{[9
]}

Sadarangani, Manish ^{[4
,5
]}

Papenburg, Jesse ^{[1
,9
,10
]}

机构：

[1] McGill Univ, Montreal Childrens Hosp, Dept Pediat, Div Pediat Infect Dis,Hlth Ctr, E05-1905,1001 Decarie Blvd, Montreal, PQ H4A 3J1, Canada

[2] Ludwig Maximilians Univ Munchen, Dr von Hauner Childrens Hosp, Div Pediat Infect Dis, Munich, Germany

[3] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Pediat Infect Dis, Toronto, ON, Canada

[4] Univ British Columbia, BC Childrens Hosp, Res Inst, Vaccine Evaluat Ctr, Vancouver, BC, Canada

[5] Univ British Columbia, Dept Pediat, Vancouver, BC, Canada

[6] Univ Alberta, Stollery Childrens Hosp, Dept Pediat, Div Pediat Infect Dis, Edmonton, AB, Canada

[7] Dalhousie Univ, Canadian Ctr Vaccinol, IWK Hlth Ctr, Halifax, NS, Canada

[8] Univ Calgary, Alberta Childrens Hosp, Dept Pediat, Sect Infect Dis, Calgary, AB, Canada

[9] McGill Univ, Sch Populat & Global Hlth, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada

[10] McGill Univ, Dept Clin Lab Med, Div Microbiol, Hlth Ctr, Montreal, PQ, Canada

来源：

INFECTION | 2024年 / 52卷 / 03期

关键词：

Influenza; Children; Antibiotic stewardship; Antibiotics; Hospitalisation; B VIRUS; INFECTIONS;

D O I：

10.1007/s15010-023-02124-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Purpose To determine characteristics associated with inappropriate antibiotic use amongst children hospitalised for influenza.Methods We performed active surveillance for laboratory-confirmed influenza hospitalizations amongst children <= 16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, from September 2010 to August 2021. Antibiotic use was presumed appropriate if any of the following indications were met: age < 1 month, immunocompromised, hemoglobinopathy, laboratory-confirmed bacterial infection, radiographically confirmed pneumonia, admission to an intensive care unit and mechanical ventilation. Regression analyses were used to identify baseline and clinical characteristics associated with antibiotic use amongst patients without an appropriate indication.Results Amongst 8971 children, 6424 (71.6%) received any antibiotics during their hospitalisation. Amongst the 4429 children without an appropriate indication, 2366 (53.2%) received antibiotics. Antibiotic use amongst children without appropriate indication differed between study centres, ranging from 33.2% to 66.1% (interquartile range [IQR] 50.6-56.3%); it did not change significantly over time (p-value for trend = 0.28). In multivariable analyses, older age (adjusted odds ratio [aOR] 0.97, 95% confidence interval [CI] 0.96-0.99), presence of any high-risk condition (aOR 0.80, 95% CI 0.70-0.92), influenza virus type B (aOR 0.8, 95% CI 0.70-0.91) and croup (aOR 0.64, 95% CI 0.49-0.83) were associated with less, whilst fever >= 38.5 degree celsius (aOR 1.82, 95% CI 1.42-2.35) and hospitalisation duration (aOR 1.12, 95% CI 1.09-1.15) were associated with more inappropriate antibiotic use.Conclusions Over two-third of children hospitalised for influenza received antibiotics, including over half of those without an appropriate indication for antibiotic treatment. Differences amongst study centres suggest the importance of contextual determinants of antibiotic use.

引用

页码：865 / 875

页数：11

共 21 条

[21] RAPID INFLUENZA TESTING IN INFANTS AND CHILDREN YOUNGER THAN 6 YEARS IN PRIMARY CARE IMPACT ON ANTIBIOTIC TREATMENT AND USE OF HEALTH SERVICES
van Esso, Diego L.
Marta Valente, Ana
Vila, Monica
Casanovas, Josep M.
de Quixano, Marta
Rodrigo, Carlos
Anton, Andres
Pumarola, Tomas
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2019, 38 (08) : E187 - E189

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