College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
Curr Pediatr Rev. 2024;21(1):67-74. doi: 10.2174/0115733963283670240401075342.
Antibiotic de-escalation therapy plays a vital role in reducing the risk of bacterial resistance across the globe. This study elucidates the significance, determinants, and outcomes pertaining to Antibiotic De-escalation (ADE). The ADE is acknowledged as a crucial component within Antimicrobial Stewardship Programs (ASPs). The proliferation of antimicrobial-resistant bacteria arises as an anticipated outcome of the extensive utilization of antibiotics, heightening researchers' apprehensions regarding this global challenge.
The primary objective of the study was to evaluate the usage of antibiotics in terms of clinical outcomes (re-admission within 30 days and therapy outcomes upon discharge), adverse events, duration of de-escalation, and duration of hospitalizations among pediatric patients admitted to a tertiary care hospital due to various infectious diseases.
A retrospective study was conducted during a four-month period, from January 2022 to April 2023, at a tertiary care facility in Ajman, United Arab Emirates. Participants included in this study were based on specific inclusion and exclusion criteria.
A total of 200 pediatric records were screened. The majority of participants, accounting for 66.0%, were female, and 54.0% were classified as Arabs in terms of race. The mean age was 7.5 years (± 2.8). The most prevalent symptoms reported were fever (98%), cough (75%), and sore throat (73%). Male participants were more inclined to present with bacterial infections (88.2%) compared to viral infections (3.8%), bacterial and viral co-illnesses (2.5%), or parasitic infections (1.3%) at the time of admission. Regarding clinical outcomes, 27% of patients were readmitted with the same infection type, while 52% did not experience readmission. The analysis also included information on the number of patients within each antibiotic therapy duration category, alongside the mean duration of antibiotic de-escalation in hours with standard deviation (± SD). The statistical significance of these associations was assessed using P-values, revealing a significant relationship (P < 0.0001) between the duration of antibiotic therapy and the time required for antibiotic de-escalation.
The study's analysis revealed that individuals readmitted to the hospital, irrespective of whether they presented with the same or a different infection type, exhibited prolonged durations of antibiotic de-escalation. This observation underscores the potential influence of the patient's clinical trajectory and the necessity for adjunctive therapeutic interventions on the duration of antibiotic de-escalation.
抗生素降阶梯治疗在全球范围内降低细菌耐药风险方面发挥着重要作用。本研究阐明了抗生素降阶梯（ADE）的意义、决定因素和结果。ADE 被认为是抗菌药物管理计划（ASPs）的重要组成部分。由于抗生素的广泛使用，抗菌药物耐药细菌的出现是一个预期的结果，这引起了研究人员对这一全球挑战的担忧。
本研究的主要目的是评估抗生素在临床结局（30 天内再入院和出院时的治疗结局）、不良事件、降阶梯持续时间和儿科患者住院时间方面的使用情况，这些患者因各种传染病入住三级保健医院。
这是一项回顾性研究，于 2022 年 1 月至 2023 年 4 月在阿拉伯联合酋长国阿治曼的一家三级保健机构进行。本研究根据具体的纳入和排除标准纳入参与者。
共筛选了 200 份儿科记录。大多数参与者（66.0%）为女性，54.0%为阿拉伯人。平均年龄为 7.5 岁（±2.8）。最常见的报告症状是发热（98%）、咳嗽（75%）和喉咙痛（73%）。男性参与者入院时更倾向于患有细菌性感染（88.2%），而病毒性感染（3.8%）、细菌性和病毒性合并疾病（2.5%）或寄生虫感染（1.3%）。在临床结局方面，27%的患者因同一感染类型再次入院，而 52%的患者没有再次入院。分析还包括每个抗生素治疗持续时间类别的患者数量，以及小时和标准差（±SD）的抗生素降阶梯持续时间平均值。使用 P 值评估这些关联的统计学意义，结果显示抗生素治疗持续时间与抗生素降阶梯所需时间之间存在显著关系（P<0.0001）。
该研究分析表明，无论患者再次入院时是否患有相同或不同类型的感染，其抗生素降阶梯持续时间都延长了。这一观察结果强调了患者临床轨迹的潜在影响以及辅助治疗干预对抗生素降阶梯持续时间的必要性。
