Antibiotic Therapy in Neonatal and Pediatric Septic Shock

Aneja, Rajesh K.; Varughese-Aneja, Ruby; Vetterly, Carol G.; Carcillo, Joseph A.

doi:10.1007/s11908-011-0197-5

Cited by 12 publications

(9 citation statements)

References 51 publications

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“…[ 1 ] Neonatal septicemia is a major cause of neonatal mortality aggravated by occurrence of multidrug resistance. [ 2 ] It is estimated that about 26% of newborns who die, do so as a result of infections that occur around birth. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

Time to positivity and antibiotic sensitivity of neonatal blood cultures

Abdelhamid

2017

J Global Infect Dis

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Background:Sepsis is a commonly encountered and potentially life-threatening problem in neonatal intensive care units, blood culture of neonatal sepsis helps in either optimizing treatment or terminating antibiotics.Materials and Methods:We determined the causative agent, time to positivity (TTP), and antibiogram of neonatal blood cultures collected in a tertiary care center, to investigate difference between early- and late-onset neonatal sepsis and to establish the time at which a blood culture could safely be considered negative, using the BacT/ALERT® 3D 60. A total of 826 clinically suspected neonates suffering from sepsis and admitted to a neonatal intensive care unit of a tertiary care hospital, Alexandria, Egypt were included in this study.Results:Eighty-five (10.29%) showed positive results. The overall TTP median was 21.1 h. Out of the 85 positive cultures, 57 (67.06%) were Gram-positive, 15 (17.65%) were Gram-negative, and 13 (15.29%) were fungi (all Candida). Coagulase-negative staphylococci were the predominant organism (41.18%). All the Gram-positive pathogenic isolates were sensitive to vancomycin and tigecycline. Among the Gram-negative isolates, maximum antibiotic sensitivity was observed for levofloxacin.Conclusion:We conclude that more than 3 days of incubation may not be required when using the BacT/ALERT® 3D 60 system.

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Section: Introductionmentioning

confidence: 99%

Time to positivity and antibiotic sensitivity of neonatal blood cultures

Abdelhamid

2017

J Global Infect Dis

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“… 4 Differences in aetiology can also be found between childhood and neonatal sepsis, with early-onset neonatal sepsis having a distinct microbial pattern. 5 Recognising sepsis in children is also significantly more challenging due to maturation-based differences in physiology (including immune system response), limitations in the communication of symptoms and diagnostic modalities. 4 6 7 Sepsis can lead to life-altering organ dysfunction if not identified quickly in children, 6 where mortality rates are reduced two-fold if treated within the first hour.…”

Section: Introductionmentioning

confidence: 99%

“…In 2020, updated Paediatric Sepsis Survival guidelines were published calling for the integration of screening standards in healthcare facilities to support rapid identification of sepsis in children 9 and provide the appropriate antimicrobial therapy at the proper time. 5 9 Established screening tools such as the Paediatric Early Warning Score may support the timeliness of detecting clinical deterioration in children that can lead to sepsis. 10 Recently, adaptations to the Sequential Organ Assessment Score (SOFA) for paediatric patients and neonates have shown promise in identifying children at risk for mortality with sepsis 11 ; however, it is controversial whether these scores provide value in low-resource environments.…”

Section: Introductionmentioning

confidence: 99%

Automated digital technologies for supporting sepsis prediction in children: a scoping review protocol

et al. 2022

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IntroductionWhile there have been several literature reviews on the performance of digital sepsis prediction technologies and clinical decision-support algorithms for adults, there remains a knowledge gap in examining the development of automated technologies for sepsis prediction in children. This scoping review will critically analyse the current evidence on the design and performance of automated digital technologies to predict paediatric sepsis, to advance their development and integration within clinical settings.Methods and analysisThis scoping review will follow Arksey and O’Malley’s framework, conducted between February and December 2022. We will further develop the protocol using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. We plan to search the following databases: Association of Computing Machinery (ACM) Digital Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Google Scholar, Institute of Electric and Electronic Engineers (IEEE), PubMed, Scopus and Web of Science. Studies will be included on children >90 days postnatal to <21 years old, predicted to have or be at risk of developing sepsis by a digitalised model or algorithm designed for a clinical setting. Two independent reviewers will complete the abstract and full-text screening and the data extraction. Thematic analysis will be used to develop overarching concepts and present the narrative findings with quantitative results and descriptive statistics displayed in data tables.Ethics and disseminationEthics approval for this scoping review study of the available literature is not required. We anticipate that the scoping review will identify the current evidence and design characteristics of digital prediction technologies for the timely and accurate prediction of paediatric sepsis and factors influencing clinical integration. We plan to disseminate the preliminary findings from this review at national and international research conferences in global and digital health, gathering critical feedback from multidisciplinary stakeholders.Scoping review registrationhttps://osf.io/veqha/?view_only=f560d4892d7c459ea4cff6dcdfacb086

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“…In late onset neonatal sepsis (>72 hours), similar broad-spectrum antibiotics are used as in early onset sepsis but 3 rd generation cephalosporins such as cefotaxime are added. Vancomycin is used instead of ampicillin in catheter-associated infections [ 19 ]. In children aged >1 month, a broad-spectrum antibiotic that covers both gram positive and gram-negative organisms are recommended, but the antibiotic choice depends on the clinical presentation, for example pneumonia, blood stream infection, intra-abdominal sepsis or meningitis that caused septic shock.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic prescribing practices in paediatric septic shock in a tertiary care hospital in a resource limited setting: an audit

Vekaria-Hirani¹,

Kumar²,

Musoke³

2019

Pan Afr Med J

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Introduction Early empiric broad spectrum antibiotic administration in children with septic shock improves outcome. Knowledge on possible bacterial aetiology, drug resistance pattern and rational choice of antibiotics is crucial in management of septic shock. Methods This was an audit carried out among 50 (0- 5 years age) children admitted with septic shock at the Kenyatta National Hospital between October to December 2016. A standard questionnaire was used for data collection as per the Surviving Sepsis Guideline. Data were stored in Excel and analyzed in Strata 12. Results Of the 50 admitted children with septic shock 86% were less than one-year age. Samples for blood cultures were removed from 12(24%) prior to administration of antibiotics. Blood culture bottles were unavailable in 80%. All children received antibiotics. Antibiotics were initiated in 44(88%) in the golden hour of diagnosis of septic shock. Monotherapy with cephalosporins 30 (60%) was the commonest choice of initial antibiotic. Antibiotics were changed in 7(22.6%) and 1(5.3%) at 24 and 48 hours respectively due to clinical deterioration. Over mortality at 72 hours was 35 (70%). All the 9 children initiated on meropenem monotherapy on admission died. Conclusion The majority of patients with septic shock were under one-year age. All patients were initiated on antibiotics. Blood cultures were done in a quarter of the patients. Monotherapy with cephalosporin was the commonest choice of antibiotic. De-escalation was not well accomplished due to microbiological culture limitation. There was no standard antibiotic choice hence antibiotic use in septic shock needs to be included in the paediatric local guidelines.

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Antibiotic Therapy in Neonatal and Pediatric Septic Shock

Cited by 12 publications

References 51 publications

Time to positivity and antibiotic sensitivity of neonatal blood cultures

Time to positivity and antibiotic sensitivity of neonatal blood cultures

Automated digital technologies for supporting sepsis prediction in children: a scoping review protocol

Antibiotic prescribing practices in paediatric septic shock in a tertiary care hospital in a resource limited setting: an audit

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