46 Association of Empiric Antibiotic Selection on Clinical Outcomes in Hospitalized Children with Severe Orbital Infections: A Multicenter Cohort Study Article Swipe
Emily Nguyen
,
Sanjay Mahant
,
Jessica Cichon
,
Cornelia M. Borkhoff
,
Olivier Drouin
,
Catherine Pound
,
Julie Quet
,
Gita Wahi
,
Ann Bayliss
,
Gemma Vomiero
,
Jessica L. Foulds
,
Ronik Kanani
,
Mahmoud Sakran
,
Anupam Sehgal
,
Eleanor Pullenayegum
,
Elysa Widjaja
,
Arun Reginald
,
Nikolaus E. Wolter
,
Patricia C. Parkin
,
Peter J. Gill
,
Carsten Krueger
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/pch/pxad055.046
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/pch/pxad055.046
Background Antibiotic selection in children with periorbital and orbital infections is often empiric and regimens vary widely among institutions in their spectrum and inclusion of anti-anaerobic and anti-staphylococcal agents. Objectives Currently, there are no national clinical guidelines for antibiotic selection and no studies comparing commonly used antibiotic regimens in orbital infections. We aimed to determine the association of initial empiric antibiotic regimens with clinical outcomes in children hospitalized with severe orbital infections. Design/Methods We conducted a multicentre cohort study of children with severe orbital infections admitted to ten hospitals between January 1, 2009, and December 31, 2018. The association between empiric antibiotic regimen in the first 24 hours of hospitalization with length of stay and surgical intervention were assessed with multivariable median regression and multivariate logistic regression, respectively. Results Of 1421 patients, 60.0% were male, and mean age was 6.4 years (SD 4.5). Median length of stay was 86.4 hours (IQR 56.9-137.5) and 180 (12.7%) received surgical intervention. The most frequently (23.6%) administered empiric regimen consisted of a third-generation cephalosporin, anaerobic agent, and staphylococcal agent. After adjustment, broad-spectrum empiric antibiotic regimens with dedicated anti-anaerobic and/or staphylococcal coverage were associated with increased length of stay, ranging from an additional 18.4 hours (95% CI, 6.82, 30.0) to 21.5 hours (95% CI, 11.0, 32.0). Only patients with staphylococcal coverage alone had a statistically significant increased odds of surgical intervention (4.45, 95% CI 1.03, 19.2). Conclusion In children hospitalized with severe orbital infections, broad-spectrum therapy with or without coverage for staphylococci and anaerobes were associated with similar clinical outcomes in a clinical setting with low methicillin-resistant Staphylococcus aureus prevalence. Clinical practice guidelines are needed to standardize antibiotic recommendations.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/pch/pxad055.046
- https://academic.oup.com/pch/article-pdf/28/Supplement_1/e20/51734698/pxad055.046.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4386989191
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4386989191Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/pch/pxad055.046Digital Object Identifier
- Title
-
46 Association of Empiric Antibiotic Selection on Clinical Outcomes in Hospitalized Children with Severe Orbital Infections: A Multicenter Cohort StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-09-01Full publication date if available
- Authors
-
Emily Nguyen, Sanjay Mahant, Jessica Cichon, Cornelia M. Borkhoff, Olivier Drouin, Catherine Pound, Julie Quet, Gita Wahi, Ann Bayliss, Gemma Vomiero, Jessica L. Foulds, Ronik Kanani, Mahmoud Sakran, Anupam Sehgal, Eleanor Pullenayegum, Elysa Widjaja, Arun Reginald, Nikolaus E. Wolter, Patricia C. Parkin, Peter J. Gill, Carsten KruegerList of authors in order
- Landing page
-
https://doi.org/10.1093/pch/pxad055.046Publisher landing page
- PDF URL
-
https://academic.oup.com/pch/article-pdf/28/Supplement_1/e20/51734698/pxad055.046.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/pch/article-pdf/28/Supplement_1/e20/51734698/pxad055.046.pdfDirect OA link when available
- Concepts
-
Medicine, Logistic regression, Antibiotics, Regimen, Empiric treatment, Odds ratio, Internal medicine, Empiric therapy, Cohort, Pediatrics, Alternative medicine, Pathology, Biology, MicrobiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- Related works (count)
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10Other works algorithmically related by OpenAlex
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