Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Infectious Diseases and Antimicrobials

Video Transcription

Video Summary

Life-threatening infections are a common reason for admission to the pediatric intensive care unit (PICU). Antibiotics play a crucial role in the management of these infections, but their use must be carefully considered to ensure appropriate coverage and to prevent the development of antibiotic resistance. In the PICU, up to 80% of patients receive at least one antibiotic, but it has been estimated that up to half of these prescriptions may be inappropriate. When selecting antibiotics, clinicians must consider the likely causative organisms, the site of infection, the ability of the antibiotic to penetrate the affected area, and the susceptibility of the organisms to the chosen antibiotic. Common life-threatening infections in the PICU include bloodstream and central nervous system infections, as well as respiratory and abdominal infections. The causative organisms can vary, but gram-positive and gram-negative bacteria are commonly involved, with methicillin-resistant Staphylococcus aureus (MRSA) and fungi also being significant pathogens. It is important to consider patient-specific factors, such as age, immunization status, geographical location, and local patterns of antibiotic resistance. Antibiotic selection should be guided by these factors and should aim to provide appropriate coverage while minimizing the risk of antibiotic resistance. Antimicrobial stewardship programs are important for promoting appropriate antibiotic use and reducing the misuse of antibiotics. These programs involve multidisciplinary teams and can help improve patient outcomes and reduce healthcare costs. Close monitoring and collaboration with infectious disease specialists are crucial in managing life-threatening infections and selecting appropriate antibiotics in the PICU.

Keywords

pediatric intensive care unit

life-threatening infections

antibiotics

antibiotic resistance

causative organisms

antimicrobial stewardship programs

infectious disease specialists

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