ArticleBMC public health2019
The use of antibiotics in the treatment of pediatric varicella patients: real-world evidence from the multi-country MARVEL study in Latin America & Europe.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- The Clinical and Economic Burden of Antibiotic Use in Pediatric Patients With Varicella Infection: A Retrospective Cohort Analysis of Real-World Data in England.The Journal of infectious diseases · 2024Article
- Global Prevalence of Varicella-Associated Complications: A Systematic Review and Meta-Analysis.Infectious diseases and therapy · 2024Article
- Economic burden of varicella in Bangkok, Thailand: A multicenter medical chart review study.PLOS global public health · 2024Article
- Regional Perspective of Antimicrobial Stewardship Programs in Latin American Pediatric Emergency Departments.Antibiotics (Basel, Switzerland) · 2023Review
- Assessing the use of antibiotics in pediatric patients hospitalized for varicella.Italian journal of pediatrics · 2022Article
- Vaccination coverage in Italian children and antimicrobial resistance: an ecological analysis.Antimicrobial resistance and infection control · 2022Article
- Recognition & management of varicella infections and accuracy of antimicrobial recommendations: Case vignettes study in the US.PloS one · 2022Article
- Article
- Assessing the use of antibiotics and the burden of varicella in Belgium using a retrospective GP database analysis.BMC infectious diseases · 2021Observational
Corrections and comments
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Authors and funding
12 authors at 10 institutions in 7 countries.
Funding
Abstract
backgroundVaricella is a highly contagious childhood disease. Generally benign, serious complications necessitating antibiotic use may occur. The objective of this study was to characterize the rate, appropriateness and patterns of real-world antibiotic prescribing for management of varicella-associated complications, prior to universal varicella vaccination (UVV) implementation.
methodsPooled, post-hoc analysis of 5 international, multicenter, retrospective chart reviews studies (Argentina, Hungary, Mexico, Peru, Poland). Inpatient and outpatient primary pediatric (1-14 years) varicella cases, diagnosed between 2009 and 2016, were eligible. Outcomes, assessed descriptively, included varicella-associated complications and antibiotic use. Three antibiotic prescribing scenarios were defined based on complication profile in chart: evidence of microbiologically confirmed bacterial infection (Scenario A); insufficient evidence confirming microbiological confirmation (Scenario B); no evidence of microbiological confirmation (Scenario C). Stratification was performed by patient status (inpatient vs. outpatient) and country.
resultsFour hundred one outpatients and 386 inpatients were included. Mean (SD) outpatient age was 3.6 (2.8) years; inpatient age was 3.1 (2.8) years. Male gender was predominant. Overall, 12.2% outpatients reported ≥1 infectious complication, 3.7% ≥1 bacterial infection, and 0.5% ≥1 microbiologically confirmed infection; inpatient complication rates were 78.8, 33.2 and 16.6%, respectively. Antibiotics were prescribed to 12.7% of outpatients and 68.9% of inpatients. Among users, β-lactamases (class), and clindamycin (agent), dominated prescriptions. Scenario A was assigned to 3.9% (outpatients) vs 13.2% (inpatients); Scenario B: 2.0% vs. 6.0%; Scenario C: 94.1% vs. 80.8%.
conclusionsHigh rates of infectious complications and antibiotic use are reported, with low rates of microbiological confirmation suggesting possible antibiotic misuse for management of varicella complications.
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