Correction: Can We Predict Oral Antibiotic Treatment Failure in Children with Fast-Breathing Pneumonia Managed at the Community Level? A Prospective Cohort Study in Malawi

Abstract Background Inappropriate use of antibiotics not only increases antibiotic resistance as collateral damage but also increases clinical failure rates and medical costs. The purpose of this study was to determine the relationship between the appropriateness of antibiotic prescription and clinical outcomes of community-acquired acute pyelonephritis (CA-APN). Methods A multicenter prospective cohort study was conducted at eight hospitals in Korea between September 2017 and August 2018. All hospitalized patients aged ≥ 19 years who were diagnosed with CA-APN on admission were recruited. The appropriateness of empirical and definitive antibiotics, as well as the appropriateness of antibiotic treatment duration and route of administration, was evaluated. Clinical outcomes were compared between patients who were administered antibiotics ‘appropriately’ and ‘inappropriately.’ Results A total of 397 and 318 patients were eligible for the analysis of the appropriateness of empirical and definitive antibiotics, respectively. Of them, 10 (2.5%) and 18 (5.7%) were administered ‘inappropriately’ empirical and definitive antibiotics, respectively. Of the 119 patients whose use of both empirical and definitive antibiotics was classified as ‘optimal,’ 57 (47.9%) received antibiotics over a longer duration than that recommended; 67 (56.3%) did not change to oral antibiotics on day 7 of hospitalization, even after stabilization of the clinical symptoms. Patients who were administered empirical antibiotics ‘appropriately’ had shorter hospitalization days (9 vs. 12.5 days, P = 0.014) and lower medical costs (2,332.7 vs. 4,531.2 USD, P = 0.007) than those who were administered them ‘inappropriately.’ Similar findings were observed for patients administered both empirical and definitive antibiotics ‘appropriately’ and those administered either empirical or definitive antibiotics ‘inappropriately’ Conclusions Appropriate use of antibiotics leads to better clinical outcomes, including reduced hospitalization duration and medical costs.

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Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. A multicentre prospective cohort study

Journal of Infection ◽

10.1016/j.jinf.2017.03.002 ◽

2017 ◽

Vol 74 (6) ◽

pp. 555-563 ◽

Cited By ~ 7

Author(s):

Aina Gomila ◽

Josep Ma Badia ◽

Jordi Carratalà ◽

Xavier Serra-Aracil ◽

Evelyn Shaw ◽

...

Keyword(s):

Cohort Study ◽

Colorectal Surgery ◽

Treatment Failure ◽

Surgical Site Infection ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Site Infection ◽

Elective Colorectal Surgery

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Management of suspected paediatric meningitis: a multicentre prospective cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2017-313913 ◽

2018 ◽

Vol 103 (12) ◽

pp. 1114-1118 ◽

Cited By ~ 4

Author(s):

Roshan Ramasamy ◽

Louise Willis ◽

Seilesh Kadambari ◽

Dominic F Kelly ◽

Paul T Heath ◽

...

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Antibiotic Treatment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Medical Professional ◽

Antibiotic Administration ◽

Medical Assessment ◽

Hospital Records ◽

Initial Hospital

ObjectiveTo quantify delays during management of children with suspected meningitis.DesignMulticentre prospective cohort study.SettingThree UK tertiary paediatric centres; June 2011–June 2012Patients388 children aged <16 years hospitalised with suspected meningitis or undergoing lumbar puncture (LP) during sepsis evaluation.Main outcome measuresTime of prehospital and in-hospital assessments, LP, antibiotic treatment and discharge; types of prehospital medical assessment and microbiological results. Data collected from hospital records and parental interview.Results220/388 (57%) children were seen by a medical professional prehospitalisation (143 by a general practitioner). Median times from initial hospital assessment to LP and antibiotic administration were 4.8 hours and 3.1 hours, respectively; 62% of children had their LP after antibiotic treatment. Median time to LP was shorter for children aged <3 months (3.0 hours) than those aged 3–23 months (6.2 hours, P<0.001) or age ≥2 years (20.3 hours, P<0.001). In meningitis of unknown cause, cerebrospinal fluid (CSF) PCR was performed for meningococcus in 7%, pneumococcus in 10% and enterovirus in 76%. When no pathogen was identified, hospital stay was longer if LP was performed after antibiotics (median 12.5 days vs 5.0 days, P=0.037).ConclusionsMost children had LP after antibiotics were administered, reducing yield from CSF culture, and PCRs were underused despite national recommendations. These deficiencies reduce the ability to exclude bacterial meningitis, increasing unnecessary hospital stay and antibiotic treatment.

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