Healio
Healio

American Academy of Pediatrics National Conference and Exhibition
October 28, 2013
1 min read
Save

Antibiotic use for RSV decreased following educational intervention

ORLANDO, Fla. — Inappropriate antibiotic usage can be decreased with an educational intervention program, according to study findings presented here.

“[Respiratory syncytial virus] is the most common cause of lower respiratory tract infections during early childhood (>90,000 hospitalizations annually),” researchers wrote. “Serious bacterial infections complicating RSV, however, are rare. Evidence based guidelines from the AAP discourage routine use of antibiotics in children admitted with bronchiolitis unless there is evidence of bacterial co-infection.”

Researchers examined charts of children with RSV pneumonia and bronchiolitis from November 2011 to February 2012 for antibiotic usage. From August to September 2012, residents and attendings were given guidelines on RSV management emphasizing that antibiotic use is not indicated for low-risk patients with RSV. During the RSV season, an education campaign and case review to address AAP guidelines on bronchiolitis were conducted. From November 2012 to February 2013 ceftriaxone use in RSV-positive patients was examined, along with other antibiotics.

From November 2011 to February 2012, 88 patients with RSV were admitted. Fifty-eight percent of those received ceftriaxone. Significant differences were not found between patients who received antibiotics compared with those who did not for length of stay, readmission rates, temperatures and white blood cell counts. Focal opacities from chest x-ray readings were associated with antibiotic use during the intervention period (P<.05).

During the post-intervention period, there were 77 patients admitted for RSV and only 37% received ceftriaxone, resulting in a 30% reduction. There was further reduction in ceftriaxone use from November 2012 (60%) to February 2013 (33%).

There was also a reduction in antibiotic use other than ceftriaxone from 23% in the pre-intervention period to 10% post-intervention.

Leonard R. Krilov, MD 

Leonard R. Krilov

“Antibiotic use is common in infants and young children hospitalized with RSV bronchiolitis, even though concommitant serious bacterial infection is rare in this condition," Leonard R. Krilov, MD, told Infectious Diseases in Children. "Although AAP guidelines suggest routine administration of antibiotics, it is not warranted in this setting Through a series of cycles of education and feedback we demonstrated the ability to significantly decrease antibiotic use in RSV infected infants and young children.”

Leonard R. Krilov, MD, can be reached at lkrilov@winthrop.org.

For more information:

Makvana S. Abstract #21262. Presented at: AAP National Conference and Exhibition; Oct. 26-29, 2013; Orlando, Fla.

Disclosure: The researchers report no relevant financial disclosures.