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@article{Kolberg:2024:cid/ciad615,
author = {Kolberg, L and Khanijau, A and van, der Velden F and Herberg, J and De, T and Galassini, R and Cunnington, A and Wright, V and Shah, P and Kaforou, M and Wilson, C and Kuijpers, T and Martinón-Torres, F and Rivero-Calle, I and Moll, H and Vermont, C and Pokorn, M and Kolnik, M and Pollard, A and Agyeman, P and Schlapbach, L and Tsolia, M and Yeung, S and Zavadska, D and Zenz, W and Schweintzger, N and Van, Der Flier M and de, Groot R and Usuf, E and Voice, M and Calvo-Bado, L and Mallet, F and Fidler, K and Levin, M and Carrol, E and Emonts, M and von, Both U and The, PERFORM Consortium},
doi = {cid/ciad615},
journal = {Clinical Infectious Diseases},
pages = {526--534},
title = {Raising AWaRe-ness of antimicrobial stewardship challenges in pediatric emergency care: results from the PERFORM study assessing consistency and appropriateness of antibiotic prescribing across Europe},
url = {http://dx.doi.org/10.1093/cid/ciad615},
volume = {78},
year = {2024}
}

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TY  - JOUR
AB  - BackgroundOptimization of antimicrobial stewardship is key to tackling antimicrobial resistance, which is exacerbated by overprescription of antibiotics in pediatric emergency departments (EDs). We described patterns of empiric antibiotic use in European EDs and characterized appropriateness and consistency of prescribing.MethodsBetween August 2016 and December 2019, febrile children attending EDs in 9 European countries with suspected infection were recruited into the PERFORM (Personalised Risk Assessment in Febrile Illness to Optimise Real-Life Management) study. Empiric systemic antibiotic use was determined in view of assigned final “bacterial” or “viral” phenotype. Antibiotics were classified according to the World Health Organization (WHO) AWaRe classification.ResultsOf 2130 febrile episodes (excluding children with nonbacterial/nonviral phenotypes), 1549 (72.7%) were assigned a bacterial and 581 (27.3%) a viral phenotype. A total of 1318 of 1549 episodes (85.1%) with a bacterial and 269 of 581 (46.3%) with a viral phenotype received empiric systemic antibiotics (in the first 2 days of admission). Of those, the majority (87.8% in the bacterial and 87.0% in the viral group) received parenteral antibiotics. The top 3 antibiotics prescribed were third-generation cephalosporins, penicillins, and penicillin/β-lactamase inhibitor combinations. Of those treated with empiric systemic antibiotics in the viral group, 216 of 269 (80.3%) received ≥1 antibiotic in the “Watch” category.ConclusionsDifferentiating bacterial from viral etiology in febrile illness on initial ED presentation remains challenging, resulting in a substantial overprescription of antibiotics. A significant proportion of patients with a viral phenotype received systemic antibiotics, predominantly classified as WHO Watch. Rapid and accurate point-of-care tests in the ED differentiating between bacterial and viral etiology could significantly improve antimicro
AU  - Kolberg,L
AU  - Khanijau,A
AU  - van,der Velden F
AU  - Herberg,J
AU  - De,T
AU  - Galassini,R
AU  - Cunnington,A
AU  - Wright,V
AU  - Shah,P
AU  - Kaforou,M
AU  - Wilson,C
AU  - Kuijpers,T
AU  - Martinón-Torres,F
AU  - Rivero-Calle,I
AU  - Moll,H
AU  - Vermont,C
AU  - Pokorn,M
AU  - Kolnik,M
AU  - Pollard,A
AU  - Agyeman,P
AU  - Schlapbach,L
AU  - Tsolia,M
AU  - Yeung,S
AU  - Zavadska,D
AU  - Zenz,W
AU  - Schweintzger,N
AU  - Van,Der Flier M
AU  - de,Groot R
AU  - Usuf,E
AU  - Voice,M
AU  - Calvo-Bado,L
AU  - Mallet,F
AU  - Fidler,K
AU  - Levin,M
AU  - Carrol,E
AU  - Emonts,M
AU  - von,Both U
AU  - The,PERFORM Consortium
DO  - cid/ciad615
EP  - 534
PY  - 2024///
SN  - 1058-4838
SP  - 526
TI  - Raising AWaRe-ness of antimicrobial stewardship challenges in pediatric emergency care: results from the PERFORM study assessing consistency and appropriateness of antibiotic prescribing across Europe
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciad615
UR  - https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad615/7307577
UR  - http://hdl.handle.net/10044/1/107057
VL  - 78
ER  -

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