Journal of Tropical Pediatrics最新文献_第9页

Prevalence of childhood obesity in Brazil: a systematic review. 巴西儿童肥胖症患病率:系统回顾。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-02-06 DOI: 10.1093/tropej/fmad017

Fabrício De Paula Santos, Eliane Aparecida Ferraz Silva, Caroline Lana Veloso Baêta, Felipe Sávio Campos, Helton Oliveira Campos

{"title":"Prevalence of childhood obesity in Brazil: a systematic review.","authors":"Fabrício De Paula Santos, Eliane Aparecida Ferraz Silva, Caroline Lana Veloso Baêta, Felipe Sávio Campos, Helton Oliveira Campos","doi":"10.1093/tropej/fmad017","DOIUrl":"https://doi.org/10.1093/tropej/fmad017","url":null,"abstract":"The present study aimed to analyze the prevalence of childhood obesity in Brazil and compare it between boys and girls. This systematic review was conducted and reported according to the guidelines outlined in the PRISMA statement. A systematic search of electronic databases, including PubMed, LILACS, and SciELO, was performed in November 2021. Studies that met the following criteria were included: (i) original quantitative studies regardless of their design; (ii) childhood obesity was clearly defined; (iii) prevalence of childhood obesity was reported or it was possible to extract from tables or figures in the text; and (iv) eligible population included children under 12 years of age. A total of 112 articles were included in the systematic review. The prevalence of childhood obesity in Brazil was of 12.2%, being 10.8% in girls and 12.3% in boys. In addition, wide heterogeneity in the childhood obesity prevalence was observed between the states, since it was 2.6% in Pará, while it was 15.8% in Rondônia. Thus, the importance of urgently implementing measures to prevent and treat childhood obesity should be emphasized aiming to reduce obese children and adolescents and future health problems in adult life resulting from this cardiovascular risk factor.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9480545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Chest radiograph findings in children with COVID-19-A retrospective analysis from a tertiary care paediatric hospital in South India. 来自南印度一家三级儿科医院的covid -19患儿胸片检查结果回顾性分析

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-02-06 DOI: 10.1093/tropej/fmad016

Kanimozhi Vendhan, Mithra Kathirrajan, Gopinathan Kathirvelu, Balasubramanian S

{"title":"Chest radiograph findings in children with COVID-19-A retrospective analysis from a tertiary care paediatric hospital in South India.","authors":"Kanimozhi Vendhan, Mithra Kathirrajan, Gopinathan Kathirvelu, Balasubramanian S","doi":"10.1093/tropej/fmad016","DOIUrl":"https://doi.org/10.1093/tropej/fmad016","url":null,"abstract":"Objective: The primary aim of this study is to document the chest X-ray findings in children with COVID-19 pneumonia. The secondary aim is to correlate chest X-ray findings to patient outcome.Methods: We performed a retrospective analysis of children (0-18 years) with SARS-CoV-2 admitted to our hospital from June 2020 to December 2021. The chest radiographs were assessed for: peribronchial cuffing, ground-glass opacities (GGOs), consolidation, pulmonary nodules and pleural effusion. The severity of the pulmonary findings was graded using a modification of the Brixia score.Results: There were a total of 90 patients with SARS-CoV-2 infection; the mean age was 5.8 years (age range 7 days to 17 years). Abnormalities were seen on the CXR in 74 (82%) of the 90 patients. Bilateral peribronchial cuffing was seen in 68% (61/90), consolidation in 11% (10/90), bilateral central GGOs in 2% (2/90) and unilateral pleural effusion in 1% (1/90). Overall the average CXR score in our cohort of patients was 6. The average CXR score in patients with oxygen requirement was 10. The duration of hospital stay was significantly longer in those patients with CXR score >9.Conclusion: The CXR score has the potential to serve as tool to identify children at high risk and may aid planning of clinical management in such patients.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9232822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early detection of glomerular dysfunction and renal tubulopathy in children with sickle cell disease in India. 印度镰状细胞病儿童肾小球功能障碍和肾小管病变的早期检测

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-02-06 DOI: 10.1093/tropej/fmad019

Sonia Karapurkar, Radha Ghildiyal, Nikita Shah, Rachna Keshwani, Sujata Sharma

{"title":"Early detection of glomerular dysfunction and renal tubulopathy in children with sickle cell disease in India.","authors":"Sonia Karapurkar, Radha Ghildiyal, Nikita Shah, Rachna Keshwani, Sujata Sharma","doi":"10.1093/tropej/fmad019","DOIUrl":"https://doi.org/10.1093/tropej/fmad019","url":null,"abstract":"Background: Sickle cell disease causes microvascular occlusion in different vascular beds. In kidneys, it leads to occult glomerular dysfunction causing asymptomatic microalbuminuria, proximal tubulopathy causing hyposthenuria and increased free water loss and distal tubulopathy causing poor urine acidification. We studied the prevalence of various types of renal dysfunction, the ability of different tests to detect it at an early stage and the correlation of these parameters in children receiving hydroxyurea (HU).Procedure: Fifty-six children (sample size calculated using SAS9.2 package) attending paediatric clinical services in a tertiary care hospital between 2 and 12 years of age diagnosed by high-performance liquid chromatography (HPLC) were enrolled. Their demographic and laboratory data including renal and urine parameters were collected. Parameters like fractional excretion of sodium (FeNa), trans tubular potassium gradient (TtKg) and free water clearance (TcH2O) were derived by calculations. Data were analysed using IBM SPSS Version 21.0 and Microsoft Office Excel 2007.Results: We found a significant number of children to have microalbuminuria (17.8%), hyposthenuria (30.4%) and impaired renal tubular potassium excretion (TtKg) (81.3%). A significant correlation was found between the dose of HU with urine osmolality (p < 0.0005) and free water clearance (p = 0.002), while all parameters showed a significant correlation with compliance with HU. Derangement in urine microalbumin and TcH2O correlated significantly with low mean haemoglobin levels (<9 g/dl).Conclusion: Renal dysfunction is common in children with SCD and can be detected early using simple urine parameters and can be prevented with an early and appropriate dosage of HU with good compliance.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of skin-to-skin vs. cloth-to-cloth contact for thermoregulation in low birth weight newborns: a randomized crossover trial. 皮肤对皮肤与布对布接触对低出生体重新生儿体温调节的效果:一项随机交叉试验。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-02-06 DOI: 10.1093/tropej/fmad013

Reshma K Pujara, Vaibhava Upadhyay, Jigar P Thacker, Bhavna B Rana, Sangita S Patel, Jigna M Joshi, Mayur K Shinde, Somashekhar M Nimbalkar, Dipen V Patel

{"title":"Efficacy of skin-to-skin vs. cloth-to-cloth contact for thermoregulation in low birth weight newborns: a randomized crossover trial.","authors":"Reshma K Pujara, Vaibhava Upadhyay, Jigar P Thacker, Bhavna B Rana, Sangita S Patel, Jigna M Joshi, Mayur K Shinde, Somashekhar M Nimbalkar, Dipen V Patel","doi":"10.1093/tropej/fmad013","DOIUrl":"https://doi.org/10.1093/tropej/fmad013","url":null,"abstract":"Objective: Skin-to-skin contact (SSC) is effective to maintain normal temperature in low birth weight (LBW) newborns. However, there are several barriers related to privacy and space availability for its optimum utilization. We used cloth-to-cloth contact (CCC), i.e. placing the newborn in Kangaroo position without removing cloths as an innovative alternative to SSC to test its efficacy for thermoregulation and feasibility as compared to SSC in LBW newborns.Methods: The newborns eligible for Kangaroo Mother Care (KMC) in step-down nursery were included in this randomized crossover trial. Newborns received SSC or CCC as per randomization on the first day and then crossed over to other group on the next day and so on. A feasibility questionnaire was asked to the mothers and the nurses. Axillary temperature was measured at various time intervals. Group comparisons were made by either using independent sample t-test or Chi-square test.Results: A total of 23 newborns received KMC for total 152 occasions in the SSC group and 149 times in the CCC group. There was no significant temperature difference between the groups at any time-point. Mean (standard deviation) gain of temperature at 120 min in the CCC group [0.43 (0.34)°C] was comparable to the SSC group [0.49 (0.36)°C] (p = 0.13). We did not observe any adverse effect of CCC. Most mothers and nurses perceived CCC feasible in hospital settings and felt that it could be feasible in-home settings too.Conclusion: CCC was safe, more feasible and not inferior to SSC for maintaining thermoregulation in LBW newborns.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9479989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants. 超声诊断早产儿新生儿呼吸窘迫综合征的可行性。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2023-02-06 DOI: 10.1093/tropej/fmad007

Lei Zheng, Hongyan Jing, Lihong Liu, Lianyi Wang

{"title":"Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants.","authors":"Lei Zheng, Hongyan Jing, Lihong Liu, Lianyi Wang","doi":"10.1093/tropej/fmad007","DOIUrl":"https://doi.org/10.1093/tropej/fmad007","url":null,"abstract":"Background: The aim of this study was to investigate the feasibility of lung ultrasound in the diagnosis of neonatal respiratory distress syndrome (NRDS) in preterm infants.Methods: One hundred and nine preterm infants were prospectively recruited. Three ultrasound diagnostic criteria were developed to diagnose preterm infants with NRDS: (A) thickened or not smooth pleural line, part of the lung field shows diffuse 'B-line' sign or alveolar-interstitial syndrome (AIS); (B) thickened or not smooth pleural line, all lung fields show AIS, signifying the 'white lung' sign; (C) thickened or rough pleural line, 'white lung' sign and 'lung consolidation' sign can be observed in any lung field.Results: The sensitivity and negative predictive value of NRDS in preterm infants with diagnostic criteria A were 100%, but the specificity and positive predictive value were 67.95 and 55.36%, respectively. The specificity and positive predictive value of diagnostic criteria B and C were 100%, while the 95% CI of diagnostic criteria B was narrower than diagnostic criteria C. The sensitivity and negative predictive value of diagnostic criteria B were higher than that of diagnostic criteria C. Of the 31 NRDS cases, 15 cases had severe NRDS and the other 16 did not have severe NRDS.Conclusion: Thickened or rough pleural line with white lung sign is an important characteristic for the diagnosis of NRDS by lung ultrasound. White lung sign combined with the lung consolidation sign had high diagnostic efficacy when distinguishing severe NRDS from not severe NRDS.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/8a/fmad007.PMC9901274.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9108560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric neurobrucellosis: a systematic review with case report. 小儿神经布鲁氏菌病:一项有病例报告的系统综述。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2022-12-05 DOI: 10.1093/tropej/fmad004

Debjyoti Dhar, Ravi Shekhar Jaipuriar, Mahammad Samim Mondal, Siva Prakash Shunmugakani, S Nagarathna, Pratima Kumari, Rohan Mahale, Pooja Mailankody, P S Mathuranath, Hansashree Padmanabha

{"title":"Pediatric neurobrucellosis: a systematic review with case report.","authors":"Debjyoti Dhar, Ravi Shekhar Jaipuriar, Mahammad Samim Mondal, Siva Prakash Shunmugakani, S Nagarathna, Pratima Kumari, Rohan Mahale, Pooja Mailankody, P S Mathuranath, Hansashree Padmanabha","doi":"10.1093/tropej/fmad004","DOIUrl":"https://doi.org/10.1093/tropej/fmad004","url":null,"abstract":"Pediatric neurobrucellosis represents a common anthropozoonosis in endemic areas but only anecdotal reports are available till date. Using appropriate search terms in the database platforms of MEDLINE, SCOPUS and Web of Sciences, we performed a systematic review of all the cases of pediatric neurobrucellosis published in the medical literature till date, in the light of a case report. The protocol was registered under PROSPERO (CRD42022333907). Our search strategy yielded 187 citations of which 51 citations were included. A total of 119 cases were reviewed. Of these cases, eight of them had insufficient data. The most common presentation was meningitis with or without encephalitis (n = 79, 71.2%). A high prevalence of cranial neuropathies (n = 22, 20.7%) was observed in the pediatric population in which abducens palsy was the most common (n = 9, 8.1%). Diagnosis was based on multimodal investigations including standard agglutination test (n = 44, 39.6%), Rose Bengal test (n = 37, 33.3%), blood culture (n = 23, 20.7%), serology (n = 20, 18.0%) and cerebrospinal fluid (CSF) culture (n = 11, 9.9%). Rifampicin-based triple drug regimen was the most commonly employed (83/102, 81.4%). Pediatric neurobrucellosis was associated with greater frequency of sequalae (5.4%), deafness (2.7%) and mortality (2.7%), when compared to that of general population. Neurobrucellosis mimics neuro-tuberculosis in various aspects. The review highlights several unique aspects of this entity in children. A high index of suspicion can ensure prompt diagnosis, timely initiation of management and favorable outcomes.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9130430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cluster-randomized controlled trial of intermittent preventive treatment in infancy using sulfadoxine-pyrimethamine (SP-IPTi): a pilot study in Nigeria. 婴儿使用磺胺多辛-乙胺嘧啶(SP-IPTi)间歇预防性治疗的整群随机对照试验:尼日利亚的一项试点研究。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2022-12-05 DOI: 10.1093/tropej/fmad001

Olumide Thomas Adeleke, Abayomi Oyenuga, Tina M Slusher, Daniel A Gbadero

{"title":"Cluster-randomized controlled trial of intermittent preventive treatment in infancy using sulfadoxine-pyrimethamine (SP-IPTi): a pilot study in Nigeria.","authors":"Olumide Thomas Adeleke, Abayomi Oyenuga, Tina M Slusher, Daniel A Gbadero","doi":"10.1093/tropej/fmad001","DOIUrl":"https://doi.org/10.1093/tropej/fmad001","url":null,"abstract":"Background: Malaria kills a child in sub-Saharan Africa every 2 min despite widely available interventions including intermittent preventive treatment in infants (IPTi). Since 2010, when World Health Organization (WHO) recommended IPTi, no country has implemented it. To our knowledge, no IPTi study has been conducted in Nigeria. Considering severity of malaria in infancy and urgency to improve malaria prevention, we proposed a study to investigate the efficacy of this intervention in reducing malarial morbidity and mortality.Objective(s): The aim of this was to determine the safety and efficacy of SP-IPTi in reducing the prevalence of asymptomatic malaria parasitemia and malarial-associated hospital admissions.Methods: We performed a cluster-randomized controlled trial in 1379 infants. SP was administered alongside routine vaccinations in immunization centers randomized to intervention groups. Infants in control groups received only routine vaccines. Malarial 'morbidity and adverse events were monitored through passive case-detection and cross-sectional surveys'.Results: SP-IPTi was safe. There was no statistically significant difference in terms of risks of asymptomatic parasitemia at 9 months, fever or hospitalization between our control and intervention groups.Conclusions: Our study demonstrated that SP-IPTi had no benefit but was well tolerated. WHO and some researchers have also reported declining efficacy of SP, due to increasing drug resistance.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10545410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The longitudinal evaluation of COVID-19 in pediatric patients and the impact of delta variant. 小儿患者COVID-19的纵向评价及δ变异的影响

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2022-12-05 DOI: 10.1093/tropej/fmac115

Asli Arslan, Zumrut Sahbudak Bal, Sema Yildirim Arslan, Nimet Melis Bilen, Gizem Guner Ozenen, Pınar Yazıcı Özkaya, Ali Yurtseven, Candan Çiçek, İsabel Raika Durusoy, Ferda Ozkinay, Zafer Kurugol

{"title":"The longitudinal evaluation of COVID-19 in pediatric patients and the impact of delta variant.","authors":"Asli Arslan, Zumrut Sahbudak Bal, Sema Yildirim Arslan, Nimet Melis Bilen, Gizem Guner Ozenen, Pınar Yazıcı Özkaya, Ali Yurtseven, Candan Çiçek, İsabel Raika Durusoy, Ferda Ozkinay, Zafer Kurugol","doi":"10.1093/tropej/fmac115","DOIUrl":"https://doi.org/10.1093/tropej/fmac115","url":null,"abstract":"Background: Pediatric patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) displayed milder symptoms than adults. However, they play an important role in case numbers and virus transmission. Therefore, we aimed to determine the epidemiological features of all pediatric patients infected with SARS-CoV-2 and put forth case numbers longitudinally throughout the delta variant dominant period.Methods: A retrospective study was conducted at a university hospital and included patients between 0 and18 years old with a SARS-CoV-2 polymerase chain reaction (PCR) positive result, including inpatients and outpatients. Epidemiological and clinical features were recorded from electronic files, and telephone visits were performed between March 2020 and December 2021.Results: During the study period, 3175 coronavirus disease 2019 (COVID-19) pediatric patients were admitted to our hospital with a mean age of 10.61 ± 4.6 years. Of the 1815 patients who could be interviewed, 85.7% reported at least one symptom. Before the delta variant period, 0-4 years aged children were more commonly infected, while school-aged children and adolescents were more common, and the rate of pediatric cases to all COVID-19 cases increased to 35.8% after the delta variant became dominant. Symptomatic cases were significantly higher before the delta variant (87.8% vs. 84.06%, p = 0.016). The hospitalization rate was higher before the delta variant (p < 0.001), whereas PICU admission showed no statistical difference.Conclusions: The frequency of school-aged children and adolescents raised with the impact of both school openings and the delta variant, and the rate of pediatric cases increased in total COVID-19 patient numbers.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10594731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing antibiotic use in culture-negative healthcare-associated infection with a 'stop' policy: a descriptive analytical study. 以“停止”政策优化培养阴性卫生保健相关感染的抗生素使用:一项描述性分析研究

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2022-12-05 DOI: 10.1093/tropej/fmac101

Sajina Sathyan, Femitha Pournami, Ajai Kumar Prithvi, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain

{"title":"Optimizing antibiotic use in culture-negative healthcare-associated infection with a 'stop' policy: a descriptive analytical study.","authors":"Sajina Sathyan, Femitha Pournami, Ajai Kumar Prithvi, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain","doi":"10.1093/tropej/fmac101","DOIUrl":"https://doi.org/10.1093/tropej/fmac101","url":null,"abstract":"Background and objectives: Many sick neonates receive antibiotics for the clinical diagnosis of probable/possible sepsis. Reports suggest rampant antibiotic use in culture-negative sepsis. We introduced an antibiotic stop policy (ASP), by defining 'completed course duration of antibiotics' in the setting of culture-negative suspected healthcare-associated infection (HAI). Antibiotic overuse days (AOD) before antibiotic stop policy (BASP) and after antibiotic stop policy (AASP) were compared.Methods: This descriptive analytical study was conducted to measure the change in AOD after implementing ASP in culture-negative HAI. We also sought to evaluate situations in which antibiotic overuse is likely (lower gestation, ventilation, central lines) and safety of the ASP, measured as not having to restart antibiotics in the week following completed course.Results: A total of 126 neonates were initiated on a new antibiotic (started or changed) for suspected HAI. Of these, 43 were excluded. Patient days of 5175 and 5208 were analyzed in BASP and AASP, respectively. Implementation of an ASP reduced AOD (from 14.49 to 3.26 AOD per 1000 patient days; p value <0.01). Safety was ensured; the number of babies who had to be restarted on antibiotics within 1 week of stopping therapy was similar in both groups. All-cause mortality and relevant morbidities were comparable between groups.Conclusions: A significant decrease in AOD after the introduction of an ASP was noted, in neonates with culture-negative suspected HAI. This difference was noted even in the most vulnerable extreme preterm babies and those requiring ventilation and central lines.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10593736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute disseminated encephalomyelitis due to a zoonotic co-infection. 由人畜共患引起的急性播散性脑脊髓炎。

IF 2 4区医学

Journal of Tropical Pediatrics Pub Date : 2022-12-05 DOI: 10.1093/tropej/fmad008

Anam Siddiqui, Shivani Randev, Nidhi Singla, Aanandi Dhavan, Vishal Guglani, Varsha Gupta

引用次数: 0