Multiprofessional Critical Care Review: Pediatric (2023)-Infectious Diseases and Antimicrobials

Video Transcription

Video Summary

Life-threatening infections in the pediatric intensive care unit (PICU) are a common reason for admission, and appropriate antibiotic therapy is crucial in these cases. Antibiotics are frequently prescribed in the PICU, but studies have shown that a significant proportion of these prescriptions may be inappropriate. When choosing an antibiotic, factors such as the likely causative organism, the site of infection, the antibiotic's ability to reach the site, and the susceptibility of the organism to the chosen antibiotic must be considered. The etiologies of life-threatening infections in the PICU include bloodstream and central nervous system (CNS) infections, with respiratory and abdominal infections also being common. Culture-negative infections are also common, and fungal and viral infections can also be present. In terms of antibiotic choices, it is important to consider patient-specific factors such as age and immunization status, geography and local resistance patterns, and the presence of chronic medical conditions. Resistance to antibiotics, particularly multidrug-resistant organisms, is a growing concern and necessitates the need for antimicrobial stewardship programs. These programs aim to reduce the misuse of antibiotics and have shown success in reducing antibiotic use, cost, and resistance patterns. In specific cases, such as meningitis, toxic shock syndrome, influenza with bacterial co-infection, and Lymyrrh syndrome, specific antibiotic choices and management strategies are necessary. Overall, a thoughtful and individualized approach to antibiotic therapy is required in the PICU to ensure appropriate coverage and to reduce the development of antibiotic resistance.

Keywords

life-threatening infections

pediatric intensive care unit

antibiotic therapy

inappropriate prescriptions

causative organism

antimicrobial stewardship programs

antibiotic resistance

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