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Antibiotics
Special Issues
Antimicrobial Stewardship in Pediatrics
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Antimicrobial Stewardship in Pediatrics

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 24708

Special Issue Editors

Dr. Radoslaw Jaworski

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
Interests: antibiotics; antimicrobial resistance; antimicrobial stewardship; clinical microbiology; pediatric cardiac surgery; postoperative intensive care
Prof. Dr. Katarzyna Dzierzanowska-Fangrat

E-Mail Website1 Website2
Guest Editor
Department of Clinical Microbiology and Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
Interests: antibiotics; antimicrobial resistance; antimicrobial stewardship; microbiome; clinical microbiology

Special Issue Information

Dear Colleagues,

We would like to invite you to submit your research on antimicrobial stewardship in pediatrics for this Special Issue of Antibiotics. Antimicrobial resistance is a global problem that affects us all. As clinicians responsible for human welfare, it is crucial that we treat sick people effectively, but we must also learn to be more prudent in the use of antibiotics. One option is to implement antimicrobial stewardship in clinical settings. Much in this area has been published already, but it is not sufficient, especially concerning pediatrics. This Special Issue therefore particularly encourages submissions in the area of antibiotic stewardship in the pediatric population. All clinical situations in which these could be effective in antibiotics usage optimalisation are welcome to submit. This concerns general pediatrics, perioperative management in all surgical areas, pediatric hematology and oncology, patients with immunological disorders, etc. The relationship between antimicrobial use and resistance also requires further investigation, and we welcome submissions in this area as well.

Dr. Radoslaw Jaworski
Dr. Katarzyna Dzierzanowska-Fangrat
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotics
  • antibiotics stewardship
  • antimicrobial resistance
  • treatment
  • antibiotic prophylaxis
  • monitoring

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Published Papers (7 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 159 KiB  
Editorial
Antimicrobial Stewardship in Pediatrics
by Radoslaw Jaworski and Katarzyna Dzierzanowska-Fangrat
Antibiotics 2024, 13(1), 105; https://doi.org/10.3390/antibiotics13010105 - 22 Jan 2024
Viewed by 1629
Abstract
Since the discovery of antibiotics in the early 20th century, significant changes have occurred in their usage principles [...] Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)

Research

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12 pages, 554 KiB  
Article
Antibiotic Resistance of Streptococcus pneumoniae in the Nasopharynx of Healthy Children Less than Five Years Old after the Generalization of Pneumococcal Vaccination in Marrakesh, Morocco
by Sara Amari, Karima Warda, Majda Bouraddane, Mostafa Katfy, Youssef Elkamouni, Lamiae Arsalane, Khalid Zerouali, Said Zouhair and Mohamed Bouskraoui
Antibiotics 2023, 12(3), 442; https://doi.org/10.3390/antibiotics12030442 - 23 Feb 2023
Cited by 2 | Viewed by 2555
Abstract
Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance [...] Read more.
Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance (MDR) of S. pneumoniae strains isolated from healthy children throughout the years 2020–2022. Antimicrobial susceptibility testing of S. pneumoniae strains in selected antimicrobials was performed using disk diffusion and E-test methods on bloodMueller–Hinton agar. The antimicrobials tested included oxacillin, amoxicillin, ceftriaxone, norfloxacin, gentamicin, vancomycin, erythromycin, clindamycin, pristinamycin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole. A total of 201 S. pneumoniae strains were isolated from the nasopharynx of healthy children in Marrakesh, Morocco. The highest rate of resistance of S. pneumoniae was found in penicillin (57.2%), followed by tetracycline (20.9%), and erythromycin (17.9%). The rates of resistance to clindamycin, trimethoprim-sulfamethoxazole, and chloramphenicol were 14.9%, 4%, and 1.5%, respectively. All isolates were susceptible to norfloxacin, gentamicin, vancomycin, and pristinamycin. Approximately 17% of all S. pneumoniae strains were resistant to at least three different antibiotic families. This study showed a low rate of antibiotics resistance among nasopharyngeal S. pneumoniae strains, and it is thus essential to monitor S. pneumoniae susceptibility in healthy children. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)
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10 pages, 810 KiB  
Article
Assessment of the Plans to Optimize Antimicrobial Use in the Pediatric Population in Catalan Hospitals: The VINCat Pediatric PROA SHARP Survey
by Borja Guarch-Ibáñez, Aurora Fernández-Polo, Sergi Hernández, Eneritz Velasco-Arnaiz, Montse Giménez, Pere Sala-Castellvi, Valentí Pineda, Susana Melendo and VINCat Pediatric PROA Group
Antibiotics 2023, 12(2), 250; https://doi.org/10.3390/antibiotics12020250 - 26 Jan 2023
Cited by 3 | Viewed by 1830
Abstract
In Spain, many programs have been introduced in recent years to optimize antimicrobial stewardship in pediatric care (known as pediatric PROA). However, information on the current situation of these programs is scarce. The present study assesses current antimicrobial use in pediatric care in [...] Read more.
In Spain, many programs have been introduced in recent years to optimize antimicrobial stewardship in pediatric care (known as pediatric PROA). However, information on the current situation of these programs is scarce. The present study assesses current antimicrobial use in pediatric care in the hospitals of Catalonia affiliated with the VINCat pediatric PROA group. Between December 2020 and January 2021, an electronic survey related to the design and use of PROA was administered to members of PROA teams in our hospital network. The survey was conducted at 26 hospitals. Twelve percent of the hospitals had pediatric PROA in operation, 42% were included in adult PROA, and 46% carried out pediatric PROA activities but not as part of an established program. At 81%, the pediatric PROA team included a pediatrician, in 58% a pharmacist, and in 54% a microbiologist. The main activities were monitoring the use of antimicrobials and bacterial resistance. Twenty-seven percent measured indicators regularly. The VINCat Pediatric PROA group’s hospitals have implemented measures for optimizing antimicrobial stewardship, but few have a pediatric PROA program in place. Specific measures and indicators must be defined, and the resources available should be increased. The development of pediatric PROA should be monitored in the coming years. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)
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7 pages, 225 KiB  
Article
Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
by Julia Burzyńska, Radoslaw Jaworski, Bohdan Maruszewski, Andrzej Kansy and Katarzyna Dzierżanowska-Fangrat
Antibiotics 2023, 12(1), 66; https://doi.org/10.3390/antibiotics12010066 - 30 Dec 2022
Cited by 4 | Viewed by 2369
Abstract
Pediatric cardiac surgery requires perioperative antibiotic prophylaxis (PAP) to reduce the risk of surgical site infections. However, the complexity of these procedures and the metabolic immaturity of children impede the establishment of PAP regimens that are both efficacious and in line with antimicrobial [...] Read more.
Pediatric cardiac surgery requires perioperative antibiotic prophylaxis (PAP) to reduce the risk of surgical site infections. However, the complexity of these procedures and the metabolic immaturity of children impede the establishment of PAP regimens that are both efficacious and in line with antimicrobial stewardship (AMS). In this study, we compared two PAP regimens: cefazolin with gentamicin (in a retrospective group) and cefazolin only (prospectively) in children undergoing elective cardiac surgery. In the prospective group, additional elements of AMS were introduced, i.e., restricted access to cefazolin and more diligent use of empirical antibiotics proceeded by consultation with an AMS team. The rate of surgical site infections (SSI), the scope of PAP deviations, and the postoperative use of antibiotics other than PAP within 30 days after surgery were analyzed. There were no significant differences in the rate of SSIs between the groups (3.9% vs. 1.2% in the prospective and retrospective groups, respectively (p = 0.35)). However, in the prospective group, the PAP violation was significantly reduced compared with the retrospective group (full compliance with the PAP regimen was 45.5% vs. 4.8%, p < 0.001, respectively). In addition, a reduction of postoperative antibiotic use was observed in the prospective group (0.991 vs. 1.932 defined daily doses, respectively). Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)
25 pages, 399 KiB  
Article
Management of Pediatric Urinary Tract Infections: A Delphi Study
by Giovanni Autore, Luca Bernardi, Claudio La Scola, Filippo Ghidini, Federico Marchetti, Andrea Pasini, Luca Pierantoni, Claudia Castellini, Claudia Gatti, Cristina Malaventura, Gabriella Pelusi, Francesco Antodaro, Andrea Bergomi, Franco Mazzini, Giovanni Parente, Roberto Pillon, Francesca Cusenza, Giacomo Biasucci, Alessandro De Fanti, Lorenzo Iughetti, Serafina Perrone, Andrea Pession, Mario Lima, Susanna Esposito and The UTI-Ped-ER Study Groupadd Show full author list remove Hide full author list
Antibiotics 2022, 11(8), 1122; https://doi.org/10.3390/antibiotics11081122 - 18 Aug 2022
Cited by 13 | Viewed by 5602
Abstract
Urinary tract infection (UTI) is one of the most common infectious diseases in the pediatric population and represents a major cause of antibiotic consumption and hospitalization in children. Considering the ongoing controversies on the management of pediatric UTI and the challenges due to [...] Read more.
Urinary tract infection (UTI) is one of the most common infectious diseases in the pediatric population and represents a major cause of antibiotic consumption and hospitalization in children. Considering the ongoing controversies on the management of pediatric UTI and the challenges due to increasing antimicrobial resistance, the aim of the present study was to evaluate the level of agreement on UTI management in pediatric age in Emilia-Romagna Region, Italy, and to assess on the basis of recent studies whether there is the need to change current recommendations used by primary care pediatricians, hospital pediatricians, and pediatric surgeons in everyday clinical practice to possibly improve outcomes. This consensus provides clear and shared indications on UTI management in pediatric age, based on the most updated literature. This work represents, in our opinion, the most complete and up-to-date collection of statements on procedures to follow for pediatric UTI, in order to guide physicians in the management of the patient, standardize approaches, and avoid abuse and misuse of antibiotics. Undoubtedly, more randomized and controlled trials are needed in the pediatric population to better define the best therapeutic management in cases with antimicrobial resistance and real usefulness of long-term antibiotic prophylaxis. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)

Review

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19 pages, 725 KiB  
Review
Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
by Gianluca Bossù, Riccardo Di Sario, Edoardo Muratore, Davide Leardini, Andrea Pession, Susanna Esposito and Riccardo Masetti
Antibiotics 2022, 11(10), 1316; https://doi.org/10.3390/antibiotics11101316 - 27 Sep 2022
Cited by 4 | Viewed by 2525
Abstract
Invasive fungal diseases (IFDs) are a relevant cause of morbidity and mortality in children with cancer. Their correct prevention and management impact patients’ outcomes. The aim of this review is to highlight the rationale and novel insights into antifungal prophylaxis and treatment in [...] Read more.
Invasive fungal diseases (IFDs) are a relevant cause of morbidity and mortality in children with cancer. Their correct prevention and management impact patients’ outcomes. The aim of this review is to highlight the rationale and novel insights into antifungal prophylaxis and treatment in pediatric patients with oncological and hematological diseases. The literature analysis showed that IFDs represent a minority of cases in comparison to bacterial and viral infections, but their impact might be far more serious, especially when prolonged antifungal therapy or invasive surgical treatments are required to eradicate colonization. A personalized approach is recommended since pediatric patients with cancer often present with different complications and require tailored therapy. Moreover, while the Aspergillus infection rate does not seem to increase, in the near future, new therapeutic recommendations should be required in light of new epidemiological data on Candidemia due to resistant species. Finally, further studies on CAR-T treatment and other immunotherapies are needed in patients with unique needs and the risk of complications. Definitive guidelines on IFD treatment considering the evolving epidemiology of antifungal resistance, new therapeutic approaches in pediatric cancer, novel antifungal drugs and the importance of an appropriate antifungal stewardship are urgently needed. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)
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Other

24 pages, 853 KiB  
Systematic Review
Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group
by Giovanni Autore, Luca Bernardi, Filippo Ghidini, Claudio La Scola, Alberto Berardi, Giacomo Biasucci, Federico Marchetti, Andrea Pasini, Maria Elena Capra, Claudia Castellini, Vera Cioni, Sante Cantatore, Andrea Cella, Francesca Cusenza, Alessandro De Fanti, Elisa Della Casa Muttini, Margherita Di Costanzo, Alessandra Dozza, Claudia Gatti, Cristina Malaventura, Luca Pierantoni, Giovanni Parente, Gabriella Pelusi, Serafina Perrone, Laura Serra, Francesco Torcetta, Enrico Valletta, Gianluca Vergine, Francesco Antodaro, Andrea Bergomi, Jennifer Chiarlolanza, Laura Leoni, Franco Mazzini, Roberto Sacchetti, Agnese Suppiej, Lorenzo Iughetti, Andrea Pession, Mario Lima, Susanna Esposito and The UTI-Ped-ER Study Groupadd Show full author list remove Hide full author list
Antibiotics 2023, 12(6), 1040; https://doi.org/10.3390/antibiotics12061040 - 12 Jun 2023
Cited by 12 | Viewed by 7322
Abstract
Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used. However, the efficacy of CAP is [...] Read more.
Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used. However, the efficacy of CAP is controversial. The aim of this document was to develop updated guidelines on the efficacy and safety of CAP to prevent pediatric UTIs. Methods: A panel of experts on pediatric infectious diseases, pediatric nephrology, pediatric urology, and primary care was asked clinical questions concerning the role of CAP in preventing UTIs in children. Overall, 15 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results: The use of CAP is not recommended in children with a previous UTI, with recurrent UTIs, with vesicoureteral reflux (VUR) of any grade, with isolated hydronephrosis, and with neurogenic bladder. CAP is suggested in children with significant obstructive uropathies until surgical correction. Close surveillance based on early diagnosis of UTI episodes and prompt antibiotic therapy is proposed for conditions in which CAP is not recommended. Conclusions: Our systematic review shows that CAP plays a limited role in preventing recurrences of UTI in children and has no effect on its complications. On the other hand, the emergence of new antimicrobial resistances is a proven risk. Full article
(This article belongs to the Special Issue Antimicrobial Stewardship in Pediatrics)
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