Title :

Distribution, Consequences, and Determinants of Time to Antibiotics in Children With Community-Onset Severe Bacterial Infection: A Secondary Analysis of a Prospective Population-Based Study.

Author(s) :

Malorey, David [Auteur]
Département de pédiatrie [CHU Nantes]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Lorton, Fleur [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Département de pédiatrie [CHU Nantes]
Chalumeau, Martin [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique [EPOPé [CRESS - U1153 / UMR_A 1125]]
Bourgoin, Pierre [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Boussicault, Gérald [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Chantreuil, Julie [Auteur]
CHU Trousseau [Tours]
Gaillot, Théophile [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Roué, Jean-Michel [Auteur]
Centre Hospitalier Régional Universitaire de Brest [CHRU Brest]
Martinot, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Assathiany, Rémy [Auteur]
Association Française de Pédiatrie Ambulatoire [AFPA]
Saulnier, Jean-Pascal [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Caillon, Jocelyne [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Grain, Audrey [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Manipulation of Lymphocytes for Immunotherapy [CRCI2NA / Eq 12]
Gras-Le Guen, Christèle [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Département de pédiatrie [CHU Nantes]
Launay, Elise [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Département de pédiatrie [CHU Nantes]

Journal title :

Pediatric Critical Care Medicine

Abbreviated title :

Pediatr Crit Care Med

Publication date :

2023-06-04

ISSN :

1529-7535

English keyword(s) :

antibiotics
bacterial infection
children
sepsis
time

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVES: To describe the distribution, consequences and potential determinants of time to antibiotics administration in children with community-onset severe bacterial infections (COSBIs). DESIGN: Secondary ...
Show more >OBJECTIVES: To describe the distribution, consequences and potential determinants of time to antibiotics administration in children with community-onset severe bacterial infections (COSBIs). DESIGN: Secondary analysis of the available data from a prospective population-based study from 2009 to 2014. SETTING: An administrative area in western France accounting for 13% of the national pediatric population. PATIENTS: All children from 1 month to 16 years old admitted to a PICU or who died before admission and had a COSBI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The time to antibiotics was divided into patient interval (from first signs of COSBI to the first medical consultation) and medical interval (from the first consultation to appropriate antibiotics administration). The association between the medical interval and child outcome was studied by a multinomial logistic regression model and the potential determinants of the patient and medical intervals were by a Cox proportional-hazards model. Of the 227 children included (median age 2.1 yr), 22 died (9.7%), and 21 (9.3%) had severe sequelae at PICU discharge. Median patient and medical intervals were 7.0 hours (interquartile range [IQR], 2.0–16.5 hr) and 3.3 hours (IQR, 1.1–12.2 hr), respectively. The last quartile of medical interval was not associated with death (adjusted odds ratio [aOR], 3.7; 95% CI, 0.8–17.5) or survival with severe sequelae (aOR, 1.3; 95% CI, 0.4–4.0) versus survival without severe sequelae. Patient interval was shorter in younger children (adjusted hazard ratio [aHR], 0.95; 95% CI, 0.92–0.99), and medical interval was reduced when the first consultation was conducted in a hospital (aHR, 1.5; 95% CI, 1.1–2.0) versus outpatient medicine. CONCLUSIONS: For children with COSBI, we found no significant association between medical interval and mortality or severe sequelae. An initial hospital referral could help reduce the time to antibiotics in COSBIs.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T01:52:33Z
2024-04-03T07:19:05Z