ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10-Center Point Prevalence Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Endotracheal Tube-Associated Complications in Paediatric Critical Care: A Systematic Review and Meta-Analysis.Nursing in critical care · 2025Pooled it
- Secondary hypoalbuminemia is independently associated with in-hospital mortality in children withAnnals of medicine · 2026Article
- Improving the culture surrounding tracheal aspirates in mechanically ventilated children.Journal of clinical microbiology · 2026Article
- Diagnostic Stewardship of Respiratory Cultures Using Clinical Decision Support in the PICU.JAMA network open · 2026Article
- Antibiotic overuse in children with viral infections: lessons from the SARS-CoV-2 pandemic.BMJ paediatrics open · 2026Article
- Article
- Antibiotic-induced gut microbiota dysbiosis in the PICU: mechanisms, clinical outcomes, and management strategies - a narrative review.Frontiers in immunology · 2026Review
- Artificial intelligence should genuinely support clinical reasoning and decision making to bridge the translational gap.NPJ digital medicine · 2025Review
- Contribution of weekly ward rounds led by pediatric infectious diseases specialists in a pediatric intensive care unit.European journal of pediatrics · 2025Observational
- Urinary Biomarkers and Attainment of Cefepime Therapeutic Targets in Critically Ill Children.The Pediatric infectious disease journal · 2025Observational
- Impact of an Antimicrobial Stewardship program on mortality and consumption of antibiotics in the intensive care units of a pediatric referral hospital in Peru.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Establishing a paediatric critical care core quality measure set using a multistakeholder, consensus-driven process.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- Protective effect of gut microbiota restored by fecal microbiota transplantation in a sepsis model in juvenile mice.Frontiers in immunology · 2024Article
- Incidence of and Risk Factors for Third-Generation Cephalosporin-ResistantInfection and drug resistance · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundAntibiotics are prescribed to most pediatric intensive care unit (PICU) patients, but data describing indications and appropriateness of antibiotic orders in this population are lacking.
methodsWe performed a multicenter point prevalence study that included children admitted to 10 geographically diverse PICUs over 4 study days in 2019. Antibiotic orders were reviewed for indication, and appropriateness was assessed using a standardized rubric.
resultsOf 1462 patients admitted to participating PICUs, 843 (58%) had at least 1 antibiotic order. A total of 1277 antibiotic orders were reviewed. Common indications were empiric therapy for suspected bacterial infections without sepsis or septic shock (260 orders, 21%), nonoperative prophylaxis (164 orders, 13%), empiric therapy for sepsis or septic shock (155 orders, 12%), community-acquired pneumonia (CAP; 118 orders, 9%), and post-operative prophylaxis (94 orders, 8%). Appropriateness was assessed for 985 orders for which an evidence-based rubric for appropriateness could be created. Of these, 331 (34%) were classified as inappropriate. Indications with the most orders classified as inappropriate were empiric therapy for suspected bacterial infection without sepsis or septic shock (78 orders, 24%), sepsis or septic shock (55 orders, 17%), CAP (51 orders, 15%), ventilator-associated infections (47 orders, 14%), and post-operative prophylaxis (44 orders, 14%). The proportion of antibiotics classified as inappropriate varied across institutions (range, 19%-43%).
conclusionsMost PICU patients receive antibiotics. Based on our study, we estimate that one-third of antibiotic orders are inappropriate. Improved antibiotic stewardship and research focused on strategies to optimize antibiotic use in critically ill children are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.