Antibiotic treatment duration for bloodstream infections in critically ill children—A survey of pediatric infectious diseases and critical care clinicians for clinical equipoise

• DOI: 10.1371/journal.pone.0272021
• Publication Date: 2022-07-26T17:32:35Z
• Authors: Sandra Pong; Robert A. Fowler; Srinivas Murthy; Jeffrey M. Pernica; Elaine Gilfoyle; Patricia Fontela; Nicholas Mitsakakis; Asha C. Bowen; Winnie Seto; Michelle Science; James S. Hutchison; Philippe Jouvet; Asgar Rishu; Nick Daneman
• Keywords: Bloodstream infection; Bacteremia

Objective To describe antibiotic treatment durations that pediatric infectious diseases (ID) and critical care clinicians usually recommend for bloodstream infections in critically ill children. Design Anonymous, online practice survey using five common pediatric-based case scenarios of infections. Setting Pediatric intensive units Canada, Australia New Zealand. Participants intensivists, nurse practitioners, ID physicians pharmacists. Main outcome measures Recommended syndromes associated with willingness to enrol patients into a trial study duration. Results Among 136 respondents, most recommended at least 10 days antibiotics with: pneumonia (65%), skin/soft tissue (74%), urinary tract (64%) intra-abdominal (drained: 90%; undrained: 99%). For central vascular catheter-associated without catheter removal, over 90% antibiotics, except caused by coagulase negative staphylococci (79%). Recommendations were less removal. In multivariable linear regression analyses, lack source control was significantly longer (+5.2 [95% CI: 4.4–6.1 days] +4.1 3.8–4.4 infections). Most (73–95%, depending on the infection) would be willing shorter versus Conclusions The majority currently There is heterogeneity self-reported duration recommendations among clinicians. Treatment similar across different syndromes. Under appropriate clinical conditions,