Authors
Kevin J Downes, Scott L Weiss, Jeffrey S Gerber, Sarah B Klieger, Julie C Fitzgerald, Fran Balamuth, Sherri E Kubis, Pam Tolomeo, Warren B Bilker, Xiaoyan Han, Irving Nachamkin, Charles Garrigan, Jennifer H Han, Ebbing Lautenbach, Susan E Coffin, Centers for Disease Control and Prevention Epicenters Program
Publication date
2017/6/1
Journal
Journal of the Pediatric Infectious Diseases Society
Volume
6
Issue
2
Pages
134-141
Publisher
Oxford University Press
Description
Background
Biomarkers that identify critically ill children with systemic inflammatory response syndrome (SIRS) at low risk for bacterial infection may help clinicians reduce unnecessary antibiotic use.
Methods
We conducted a prospective cohort study of children with SIRS and suspected infection admitted to a pediatric intensive care unit from January 5, 2012 to March 7, 2014. We enrolled patients upon initiation of new antibiotics (Time 0) and measured a panel of 8 serum biomarkers daily over 72 hours. Microbiology, imaging, and clinical data were reviewed to classify bacterial infections using Centers for Disease Control and Prevention definitions. We identified cut points of biomarker combinations to maximize the negative predictive value (NPV) and specificity for bacterial infection. Excess antibiotics were calculated as days of therapy beyond day 2 after SIRS onset in …
Scholar articles
KJ Downes, SL Weiss, JS Gerber, SB Klieger… - Journal of the Pediatric Infectious Diseases Society, 2017