降钙素原引导下的抗生素管理策略对小儿镰状细胞病患者发热的影响。

Q2 Medicine

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-08-01 Epub Date: 2025-08-11 DOI:10.5863/JPPT-24-00085

Hannah Robinson, Andrew B Gainey, Robert Daniels, Shannon DeRienzo, Deborah Hurley, Angie Brown, Carla Roberts, Anna-Kathryn Burch

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引用次数: 0

摘要

目的：本研究评估儿科镰状细胞病（SCD）发热患者（包括诊断为急性胸综合征（ACS）和/或血管闭塞危像（VOC）的患者）抗生素使用时间与降钙素原（PCT）使用的关系。方法：这项多中心、回顾性队列研究比较了2个队列中发热儿童SCD患者的抗生素使用时间，1个使用PCT （PCT队列）和1个不使用PCT （no-PCT队列）。次要终点比较了PCT对诊断为ACS和/或VOC的患者抗生素持续时间的影响。结果：共纳入258例患者。PCT队列的总体平均抗生素持续时间为4.2天（SD 2.6） vs 4.7天（SD 3.6）（p = 0.991）。对于被诊断为ACS的患者（n = 17）， PCT队列中的平均抗生素持续时间为6天（SD 2.2），而9.7天（SD 3.5）（p = 0.037; n = 7）。诊断为VOC和ACS的患者（n = 40）在PCT队列中平均为5.6天（SD 1.9） vs 9.3天（SD 3.2）（p = 0.002; n = 9）。回归分析显示，在无pct队列中，ACS患者（OR 1.51, 95% CI 1.07-2.13, p = 0.019）和同时患有VOC和ACS的患者（OR 1.72, 95% CI 1.22-2.42, p = 0.002）抗生素持续时间较长的几率增加。结论：各队列间抗生素总使用时间无显著差异。然而，在PCT队列中，诊断为ACS或VOC和ACS的患者的抗生素持续时间显着减少，平均减少3.7天的抗生素。

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Impact of a Procalcitonin Guided Antibiotic Management Strategy in Pediatric Sickle Cell Patients With Fever.

Objective: This study assessed the relationship between antibiotic durations and the use of procalcitonin (PCT) in febrile pediatric patients with sickle cell disease (SCD), including those diagnosed with acute chest syndrome (ACS) and/or vaso-occlusive crisis (VOC).

Methods: This multicenter, retrospective cohort study compared antibiotic durations in febrile pediatric SCD patients between 2 cohorts, 1 utilizing PCT (PCT cohort) and 1 not utilizing PCT (no-PCT cohort). Secondary endpoints compared the impact of PCT on antibiotic durations in those also diagnosed with ACS and/or VOC.

Results: A total of 258 patient encounters were included. The overall mean antibiotic duration in the PCT cohort was 4.2 days (SD 2.6) vs 4.7 days (SD 3.6) (p = 0.991). For those diagnosed with ACS (n = 17), the mean antibiotic duration was 6 days (SD 2.2) in the PCT cohort vs 9.7 days (SD 3.5) (p = 0.037; n = 7). Those diagnosed with both VOC and ACS (n = 40) averaged 5.6 days (SD 1.9) in the PCT cohort vs 9.3 days (SD 3.2) (p = 0.002; n = 9). Regression analyses revealed an increased odds of longer antibiotic duration in the no-PCT cohort for those with ACS (OR 1.51, 95% CI 1.07-2.13, p = 0.019), and for those with both VOC and ACS (OR 1.72, 95% CI 1.22-2.42, p = 0.002).

Conclusions: There was not a significant difference in overall antibiotic durations between cohorts. However, in the PCT cohort there was a significant reduction of antibiotic durations seen in patients diagnosed with ACS or VOC and ACS, averaging 3.7 fewer days of antibiotics.

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来源期刊

Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

2.40

自引率

0.00%

发文量

期刊介绍： The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.