Campbell Anita J, Tong Steven Y C, Davis Joshua S, Munro Alasdair P S, Blyth Christopher C, Bowen Asha C
Department of Infectious Diseases, Perth Children's Hospital, Perth, WA, Australia.
Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.
Front Pediatr. 2019 Jun 18;7:249. doi: 10.3389/fped.2019.00249. eCollection 2019.
Pediatric bacteraemia is one of the leading causes of community-acquired blood-stream infection in the developed world; however, our understanding of management practices by treating clinicians is limited. The authors designed a web-based clinician survey with support from the Australian and New Zealand Pediatric Infectious Diseases group, of the Australasian Society of Infectious Diseases. Clinicians were presented with three pediatric cases of varying severity. Antibiotic choice, durations of intravenous and oral therapy and research priorities for pediatric bacteraemia trials were gauged. Large variation in antibiotic prescribing amongst clinicians is demonstrated and increased, corresponding with escalating case complexity and persisting MRSA bacteraemia. Most clinicians chose defining optimal duration of therapy for bacteraemia as their top clinical trial priority. These findings highlight the importance of prioritizing pediatric bacteraemia clinical trials, to inform guidelines and best practice management.
小儿菌血症是发达国家社区获得性血流感染的主要原因之一；然而，我们对临床治疗医生的管理实践了解有限。作者在澳大利亚和新西兰儿科传染病组（澳大利亚传染病协会的一部分）的支持下，设计了一项基于网络的临床医生调查。向临床医生展示了三个不同严重程度的儿科病例。评估了抗生素选择、静脉和口服治疗的持续时间以及小儿菌血症试验的研究重点。结果表明，临床医生之间抗生素处方存在很大差异，且随着病例复杂性的增加和耐甲氧西林金黄色葡萄球菌菌血症的持续存在而增加。大多数临床医生选择确定菌血症的最佳治疗持续时间作为他们临床试验的首要重点。这些发现突出了优先开展小儿菌血症临床试验以指导指南制定和最佳实践管理的重要性。
