Antibiotic use in kids too long

Australian experts find use in children can be stopped sooner

Top researchers from the Murdoch Childrens Research Institute have conducted a systematic review into the duration of intravenous antibiotics for children with bacterial infections.

Analysing data on 36 different bacterial infections in children that represent the vast majority of those requiring antibiotic treatment, the researchers found many traditional courses are too long, keeping children in hospital unnecessarily and potentially promoting resistance.

Shorter antibiotic courses can affect antimicrobial resistance in a positive way, they write.

Based on their findings, the authors have created guidelines for healthcare practitioners on when it is safe and appropriate to switch from intravenous to oral antibiotics.

This decision can be made by referring to the new guiding principles, such as whether the child:

  • is able to tolerate oral medication (not vomiting);
  • has no impairment to absorption (e.g. mucositis);
  • is clinically stable without signs of severe sepsis (fever alone need not prevent switch);
  • has access to the appropriate oral antibiotics; and,
  • is able to adhere to the oral antibiotics.

In this way, the IV-oral switch can occur earlier than previous recommended for some infections.

“Antibiotics are prescribed for most children. We have provided practical and evidence-based advice on when doctors can shorten courses of antibiotics to help in the fight against resistance,” says senior author Associate Professor Penelope Bryant

“Antibiotic resistance is a growing problem in Australia and worldwide. We need to start using antibiotics better right now, and this study is about using the evidence to promote smarter antibiotic prescribing for children,” she says.

While the results can be applied to most patients, the authors point out that any new recommendations should be used as part of tailored treatment to each individual, taking into account each patient’s condition, considering underlying immunodeficiency, infection severity, and rate of recovery.

The study was published in The Lancet Infectious Diseases. Read the full report here.

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