Impact of viral testing on duration of antibiotic treatment and hospitalisation of febrile infants

Author:

Erdem G.1ORCID,Watson J. R.1,Tomatis C.1,Ceyhan K.2,Barson W.1

Affiliation:

1. Section of Infectious Diseases, Department of Pediatrics Nationwide Children's Hospital and The Ohio State University School of Medicine Columbus Ohio USA

2. Department of Neurosurgery The Ohio State University School of Medicine Columbus Ohio USA

Abstract

AbstractAimTo assess the duration of antimicrobial treatment; hospital length of stay; and invasive bacterial infections rates in hospitalised infants following the adoption of a management guideline.MethodsFaculty agreed to a standard of 24 h of antibiotic treatment for well‐appearing febrile infants with proven viral infection and no growth on bacterial cultures. The outcomes were the duration of hospitalisation and antibiotic treatment of febrile infants less than 8 weeks of age who have enterovirus, parechovirus, respiratory viruses detected. We monitored re‐admissions and missed invasive infections.ResultsOf the total 1696 infants studied, the median antibiotic treatment duration decreased from 31.5 to 24.8 h in virus‐infected infants ≤21 days of age (p = 0.02) and from 26 to 19.7 h in infants 22–56 days of age (p < 0.001). The decrease was less in infants not infected with a virus. No patient had an invasive infection identified after discharge.ConclusionThe implementation of our care standard resulted in reduction in antibiotic treatment duration without known delayed diagnosis of bacterial infections. Infants without a proven viral aetiology may need further study to inform management decisions.

Publisher

Wiley

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