Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Short Antibiotic Courses Safer for Breathing-Tube Infections in Children

06.05.2011
Study shows need for judicious use of drugs to curb antibiotic resistance

Short courses of antibiotics appear just as effective as longer ones — and a great deal safer — in treating respiratory infections that might cause pneumonia in children on temporary breathing devices, according to a Johns Hopkins Children’s Center study published online May 3 in Clinical Infectious Diseases.

In the study’s analysis of 150 children treated with antibiotics for respiratory infections while on a ventilator, longer antibiotic courses did not only fail to confer extra protection against full-blown pneumonia when compared with shorter therapy, but also considerably increased a child’s risk for developing drug-resistant infections within a month.

To rein in the spread of bacterial drug resistance, the researchers advise clinicians to carefully evaluate the need for antibiotics in the first place and to use antibiotics for the shortest time needed to achieve clinical effect.

“Our study underscores the old physician maxim to first do no harm,” said lead investigator Pranita Tamma, M. D., an infectious disease specialist at Hopkins Children’s. “Longer treatment is not always more effective, and it could be downright dangerous.”

Children on ventilators often develop respiratory infections, or tracheitis, because the breathing tubes allow bacteria an easy entry into the respiratory tract. These children need antibiotics promptly to prevent the infection from spreading into the lungs, but the optimal length of treatment has been unclear.

“We hope that our findings will help clear up some of the confusion and discourage physicians from preemptively opting for longer treatments,” Tamma said.

The Johns Hopkins investigators analyzed three years worth of medical records involving more than 1,600 children, age 18 and younger, who spent at least two days on a breathing tube. Of them, 150 got antibiotics for ventilator-related upper respiratory infections, however only 118 of them met clinical criteria for such infections, and 32 were treated merely on suspicion of infection.

Of the 82 children with actual infections who were treated with antibiotics for more than a week, 23 percent developed pneumonia, compared to 20 percent of the 36 children who got antibiotics for seven days or fewer. However, children who received the lengthy antibiotic course were five times more likely, on average, to develop drug-resistant infections following the treatment. Children who got multiple antibiotics were three times as likely to do so.

Although the length of antibiotic use made no statistical difference in pneumonia risk, the length of intubation did. Children whose tubes were left in after diagnosis of infection and start of therapy were four times more likely to progress to pneumonia than children taken off the ventilator promptly after diagnosis and start of treatment, the researchers found. The finding emphasizes the need for careful daily reassessment of each child’s need to stay on a ventilator, they added.

Past research has shown that more than one-third of antibiotic prescriptions for upper respiratory infections in the intensive care unit may be unwarranted, the investigators noted.

“Beyond fueling drug resistance, antibiotics can cause serious side effects and add to healthcare costs. We, as physicians, should ask ourselves two critical questions any time we prescribe them: ‘Does this patient really need antibiotics?’ If so, ‘what is the shortest course of treatment that will achieve clinical benefit?’” said senior investigator Sara Cosgrove, M.D., an infectious disease specialist at Hopkins.

Other investigators in the study included Alison Turnbull, Ph.D., Aaron Milstone, M.D., M.H.S., Christoph Lehmann, M.D., and Emily Sydnor, M.D., all of Hopkins.

The research was funded by the National Institutes of Health.

Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children’s is consistently ranked among the top children's hospitals in the nation. Hopkins Children’s is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. Hopkins Children's will celebrate its 100th anniversary and move to a new home in 2012. For more information, please visit www.hopkinschildrens.org

Ekaterina Pesheva | EurekAlert!
Further information:
http://www.jhmi.edu

More articles from Health and Medicine:

nachricht Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

How herpesviruses win the footrace against the immune system

26.05.2017 | Life Sciences

Water forms 'spine of hydration' around DNA, group finds

26.05.2017 | Life Sciences

First Juno science results supported by University of Leicester's Jupiter 'forecast'

26.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>