Arun S. Karthikeyan, M. Srinivasan, S. Kanungo, Bireshwar Sinha, Ankita Shrivastava, K. Ramanujam, S. Ganesan, S. Subramaniam, K. Sindhu, S. Krishna, P. Samuel, W. Rose, V. Mohan, B. Veeraraghavan, Temsunaro Rongsen-Chandola, S. Dutta, A. Bavdekar, J. John, G. Kang
{"title":"儿童发热用抗生素:来自印度人群肠道热监测的发现","authors":"Arun S. Karthikeyan, M. Srinivasan, S. Kanungo, Bireshwar Sinha, Ankita Shrivastava, K. Ramanujam, S. Ganesan, S. Subramaniam, K. Sindhu, S. Krishna, P. Samuel, W. Rose, V. Mohan, B. Veeraraghavan, Temsunaro Rongsen-Chandola, S. Dutta, A. Bavdekar, J. John, G. Kang","doi":"10.1093/infdis/jiab115","DOIUrl":null,"url":null,"abstract":"Abstract Background Acute febrile illness in children is frequently treated with antibiotics. However, the inappropriate use of antibiotics has led to the emergence of multidrug-resistant pathogens. Methods We measured use of antibiotics for fever in 4 pediatric cohorts that were part of the Surveillance for Enteric Fever in India (SEFI) network. In this network, 24 062 children were followed up weekly, capturing information on fever and other morbidity between October 2017 and December 2019. Results An antibiotic was given in 27 183 of the 76 027 (35.8%) episodes of fever. The incidence of fever-related antibiotic use was 58.0 (95% confidence interval [CI], 57.2–58.6) per 100 child-years. The median time to initiation of antibiotics was 4 days, and in 65% of those who received an antibiotic it was initiated by the second day. Antibiotics were continued for <3 days in 24% of the episodes. Higher temperature, younger age, male sex, joint family, higher education, internet access, and availability of personal conveyance were associated with antibiotic treatment for fever. Conclusions In developing countries where antibiotic use is not regulated, broad-spectrum antibiotics are initiated early, and often inappropriately, in febrile illness. Frequent and inappropriate use of antibiotics may increase risk of antimicrobial resistance.","PeriodicalId":22572,"journal":{"name":"The Indonesian Journal of Infectious Diseases","volume":"77 1","pages":"S494 - S501"},"PeriodicalIF":0.0000,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Antibiotics for Fever Among Children: Findings From the Surveillance for Enteric Fever in India Cohorts\",\"authors\":\"Arun S. Karthikeyan, M. Srinivasan, S. Kanungo, Bireshwar Sinha, Ankita Shrivastava, K. Ramanujam, S. Ganesan, S. Subramaniam, K. Sindhu, S. Krishna, P. Samuel, W. Rose, V. Mohan, B. Veeraraghavan, Temsunaro Rongsen-Chandola, S. Dutta, A. Bavdekar, J. John, G. Kang\",\"doi\":\"10.1093/infdis/jiab115\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Background Acute febrile illness in children is frequently treated with antibiotics. However, the inappropriate use of antibiotics has led to the emergence of multidrug-resistant pathogens. Methods We measured use of antibiotics for fever in 4 pediatric cohorts that were part of the Surveillance for Enteric Fever in India (SEFI) network. In this network, 24 062 children were followed up weekly, capturing information on fever and other morbidity between October 2017 and December 2019. Results An antibiotic was given in 27 183 of the 76 027 (35.8%) episodes of fever. The incidence of fever-related antibiotic use was 58.0 (95% confidence interval [CI], 57.2–58.6) per 100 child-years. The median time to initiation of antibiotics was 4 days, and in 65% of those who received an antibiotic it was initiated by the second day. Antibiotics were continued for <3 days in 24% of the episodes. Higher temperature, younger age, male sex, joint family, higher education, internet access, and availability of personal conveyance were associated with antibiotic treatment for fever. Conclusions In developing countries where antibiotic use is not regulated, broad-spectrum antibiotics are initiated early, and often inappropriately, in febrile illness. Frequent and inappropriate use of antibiotics may increase risk of antimicrobial resistance.\",\"PeriodicalId\":22572,\"journal\":{\"name\":\"The Indonesian Journal of Infectious Diseases\",\"volume\":\"77 1\",\"pages\":\"S494 - S501\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Indonesian Journal of Infectious Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/infdis/jiab115\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Indonesian Journal of Infectious Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/infdis/jiab115","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Antibiotics for Fever Among Children: Findings From the Surveillance for Enteric Fever in India Cohorts
Abstract Background Acute febrile illness in children is frequently treated with antibiotics. However, the inappropriate use of antibiotics has led to the emergence of multidrug-resistant pathogens. Methods We measured use of antibiotics for fever in 4 pediatric cohorts that were part of the Surveillance for Enteric Fever in India (SEFI) network. In this network, 24 062 children were followed up weekly, capturing information on fever and other morbidity between October 2017 and December 2019. Results An antibiotic was given in 27 183 of the 76 027 (35.8%) episodes of fever. The incidence of fever-related antibiotic use was 58.0 (95% confidence interval [CI], 57.2–58.6) per 100 child-years. The median time to initiation of antibiotics was 4 days, and in 65% of those who received an antibiotic it was initiated by the second day. Antibiotics were continued for <3 days in 24% of the episodes. Higher temperature, younger age, male sex, joint family, higher education, internet access, and availability of personal conveyance were associated with antibiotic treatment for fever. Conclusions In developing countries where antibiotic use is not regulated, broad-spectrum antibiotics are initiated early, and often inappropriately, in febrile illness. Frequent and inappropriate use of antibiotics may increase risk of antimicrobial resistance.