Risk Factors Associated With Prolonged Antibiotic Use in Pediatric Bacterial Meningitis

作者全名："He, Cuiyao; Hu, Xiaogang; Li, Tingsong; Wu, Qing; Fan, Jisan; Zhou, Yan; Jiang, Li; Hong, Siqi; Luo, Yuanyuan"

作者地址："[He, Cuiyao; Wu, Qing; Fan, Jisan; Zhou, Yan] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Pharm,Childrens Hosp, Minist Educ,Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Hu, Xiaogang] Chongqing Univ, Canc Hosp, Dept Pharm, Chongqing, Peoples R China; [Li, Tingsong] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Rehabil,Childrens Hosp, Minist Educ,Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Jiang, Li; Hong, Siqi; Luo, Yuanyuan] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Neurol,Childrens Hosp, Minist Educ,Key Lab Child Dev & Disorders, Chongqing, Peoples R China"

通信作者："Luo, YY (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Neurol,Childrens Hosp, Minist Educ,Key Lab Child Dev & Disorders, Chongqing, Peoples R China."

来源：FRONTIERS IN PHARMACOLOGY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000820852300001

JCR分区：Q1

影响因子：5.6

年份：2022

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：bacterial meningitis; children; augmented renal clearance; antibiotic; infectious disease

摘要："Objectives: To determine the risk factors associated with a prolonged antibiotic course for community-acquired bacterial meningitis (BM) in children.Methods: This retrospective cohort study included children aged 1 month to 18 years with community-acquired BM due to a confirmed causative pathogen from 2011 to 2021. Patients were divided into an antibiotic prolongation group and a nonprolongation group according to whether the antibiotic course exceeded 2 weeks of the recommended course for the causative pathogen. Associations of important clinical characteristics and laboratory and other parameters with antibiotic prolongation were assessed using univariate and multivariable regression logistic analyses.Results: In total, 107 patients were included in this study. Augmented renal clearance (ARC) (OR, 19.802; 95% CI, 7.178-54.628; p < 0.001) was associated with a prolonged antibiotic course; however, septic shock, causative pathogen, preadmission antibiotic use, peripheral white blood cell (WBC) count, initial cerebrospinal fluid (CSF) WBC count, CSF glucose, CSF protein, and surgical intervention were not associated with the prolonged antibiotic course. Patients with ARC had more total fever days (median time: 14 vs. 7.5 days), longer hospitalization (median time: 39 vs. 24 days), higher rates of complications (72.34% vs. 50.00%) and antibiotic adjustments (78.723% vs. 56.667%) than patients with normal renal function.Conclusion: ARC is an independent risk factor for prolonged antibiotic use in children with community-acquired BM. ARC may be associated with longer fever and hospitalization durations, higher rates of complications and antibiotic adjustments."

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