Journal article
Variability in Pediatric Infectious Disease Consultants' Recommendations for Management of Community-Acquired Pneumonia
PloS one, Vol.6(5), pp.e20325-e20325
05/31/2011
DOI: 10.1371/journal.pone.0020325
PMCID: PMC3105054
PMID: 21655259
Abstract
Background: Community-acquired pneumonia (CAP) is a common childhood infection. CAP complications, such as parapneumonic empyema (PPE), are increasing and are frequently caused by antibiotic-resistant organisms. No clinical guidelines currently exist for management of pediatric CAP and no published data exist about variations in antibiotic prescribing patterns. Our objectives were to describe variation in CAP clinical management for hospitalized children by pediatric infectious disease consultants and to examine associations between recommended antibiotic regimens and local antibiotic resistance levels.
Methods: We surveyed pediatric members of the Emerging Infections Network, which consists of 259 pediatric infectious disease physicians. Participants responded regarding their recommended empiric antibiotic regimens for hospitalized children with CAP with and without PPE and their recommendations for duration of therapy. Participants also provided information about the prevalence of penicillin non-susceptible S. pneumoniae and methicillin-resistant S. aureus (MRSA) in their community.
Results: We received 148 responses (57%). For uncomplicated CAP, respondents were divided between recommending beta-lactams alone (55%) versus beta-lactams in combination with another class (40%). For PPE, most recommended a combination of a beta-lactam plus an anti-MRSA agent, however, they were divided between clindamycin (44%) and vancomycin (57%). The relationship between reported antibiotic resistance and empiric regimen was mixed. We found no relationship between aminopenicillin use and prevalence of penicillin non-suscepetible S. pneumoniae or clindamycin use and clindamycin resistance, however, respondents were more likely to recommend an anti-MRSA agent when MRSA prevalence increased.
Conclusions: Substantial variability exists in recommendations for CAP management. Development of clinical guidelines via antimicrobial stewardship programs and dissemination of data about local antibiotic resistance patterns represent opportunities to improve care.
Details
- Title: Subtitle
- Variability in Pediatric Infectious Disease Consultants' Recommendations for Management of Community-Acquired Pneumonia
- Creators
- Adam L. Hersh - University of UtahDaniel J. Shapiro - University of California, San FranciscoJason G. Newland - Children's Mercy HospitalPhilip M. Polgreen - University of IowaSusan E. Beekmann - University of IowaSamir S. Shah - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.6(5), pp.e20325-e20325
- DOI
- 10.1371/journal.pone.0020325
- PMID
- 21655259
- PMCID
- PMC3105054
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library Science
- Number of pages
- 6
- Grant note
- T32HD044331 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) U50 CCU112346 / Centers for Disease Control and Prevention (CDC); United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 05/31/2011
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359943902771
Metrics
6 Record Views