Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
No Clinical Benefit of Empirical Antimicrobial Therapy for Pediatric Diarrhea in a High-Usage, High-Resistance Setting.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- A public resource of 15 genomically characterized representative strains ofMicrobial genomics · 2026Article
- Enhanced virulence and stress tolerance are signatures of epidemiologically successful Shigella sonnei.Nature communications · 2025Article
- High Frequency of Viral Etiology and Antibiotic Utilization Patterns in Pediatric Acute Diarrhea: A Cross-Sectional Study at a Tertiary Hospital in Vietnam.Turkish archives of pediatrics · 2025Article
- Review
- Enhancing pathogen description and antibiotic regimen selection in community-acquired pneumonia through RT-qPCR assays.Frontiers in microbiology · 2024Article
- Multidrug resistance plasmids underlie clonal expansions and international spread of Salmonella enterica serotype 1,4,[5],12:i:- ST34 in Southeast Asia.Communications biology · 2023Article
- The seroincidence of childhood Shigella sonnei infection in Ho Chi Minh City, Vietnam.PLoS neglected tropical diseases · 2023Article
- Conditions Necessary for the Transfer of Antimicrobial Resistance in Poultry Litter.Antibiotics (Basel, Switzerland) · 2023Article
- [Shigellosis attended in the emergency department of a regional hospital in southeastern Spain: from their presence to multiresistance].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Article
- Characteristics of bloodstream infection and initial antibiotic use in critically ill burn patients and their impact on patient prognosis.Scientific reports · 2022Article
- Prevalence of Multidrug-Resistant and Extended-Spectrum Beta-Lactamase-ProducingAntibiotics (Basel, Switzerland) · 2022Review
- Article
- The Gut Microbiome of Healthy Vietnamese Adults and Children Is a Major Reservoir for Resistance Genes Against Critical Antimicrobials.The Journal of infectious diseases · 2021Article
- Genomic insights into the circulation of pandemic fluoroquinolone-resistant extra-intestinal pathogenicMicrobial genomics · 2021Article
- Evolutionary histories and antimicrobial resistance in Shigella flexneri and Shigella sonnei in Southeast Asia.Communications biology · 2021Article
- The identification of novel immunogenic antigens as potential Shigella vaccine components.Genome medicine · 2021Article
- Comprehensive Description of Pathogens and Antibiotic Treatment Guidance in Children With Community-Acquired Pneumonia Using Combined Mass Spectrometry Methods.Frontiers in cellular and infection microbiology · 2021Article
- Genomic Serotyping, Clinical Manifestations, and Antimicrobial Resistance of NontyphoidalJournal of clinical microbiology · 2020Article
- Genomic epidemiology of Campylobacter jejuni associated with asymptomatic pediatric infection in the Peruvian Amazon.PLoS neglected tropical diseases · 2020Article
- Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the south of Vietnam.BMC microbiology · 2020Article
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Abstract
Background: Pediatric diarrheal disease presents a major public health burden in low- to middle-income countries. The clinical benefits of empirical antimicrobial treatment for diarrhea are unclear in settings that lack reliable diagnostics and have high antimicrobial resistance (AMR). Methods: We conducted a prospective multicenter cross-sectional study of pediatric patients hospitalized with diarrhea containing blood and/or mucus in Ho Chi Minh City, Vietnam. Clinical parameters, including disease outcome and treatment, were measured. Shigella, nontyphoidal Salmonella (NTS), and Campylobacter were isolated from fecal samples, and their antimicrobial susceptibility profiles were determined. Statistical analyses, comprising log-rank tests and accelerated failure time models, were performed to assess the effect of antimicrobials on disease outcome. Results: Among 3166 recruited participants (median age 10 months; interquartile range, 6.5-16.7 months), one-third (1096 of 3166) had bloody diarrhea, and 25% (793 of 3166) were culture positive for Shigella, NTS, or Campylobacter. More than 85% of patients (2697 of 3166) were treated with antimicrobials; fluoroquinolones were the most commonly administered antimicrobials. AMR was highly prevalent among the isolated bacteria, including resistance against fluoroquinolones and third-generation cephalosporins. Antimicrobial treatment and multidrug resistance status of the infecting pathogens were found to have no significant effect on outcome. Antimicrobial treatment was significantly associated with an increase in the duration of hospitalization with particular groups of diarrheal diseases. Conclusions: In a setting with high antimicrobial usage and high AMR, our results imply a lack of clinical benefit for treating diarrhea with antimicrobials; adequately powered randomized controlled trials are required to assess the role of antimicrobials for diarrhea.
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