Archives de pediatrie : organe officiel de la Societe francaise de pediatrie · 2025
Impact of the francophone pediatric intensive care group bronchiolitis recommendations on diagnostic testing, antibiotic therapy and patient prognosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Labe Pauline, Bendavid Matthieu, Toubiana Julie, Anquetil Céline, Oualha Mehdi, Collignon Charlotte
Аннотация
BACKGROUND: Acute bronchiolitis is a common viral infection in infants, with severe cases requiring admission to pediatric intensive care units (PICU). While bacterial co-infections are rare, timely diagnosis and management are essential. Updated guidelines from the French-speaking Group of Pediatric Intensive and Emergency Care (GFRUP) aim to standardize the standard of care, reducing unnecessary interventions.
OBJECTIVES: This study evaluated the impact of updated bronchiolitis management guidelines on sepsis incidence, diagnostic test use, and antibiotic prescriptions in a single center.
METHODS AND SETTINGS: A retrospective study compared two epidemic periods (2022-2023 and 2023-2024) at the PICU, Necker-Enfants Malades Hospital. Clinical and microbiological data, including sepsis incidence, bacterial co-infections, diagnostic tests, and antibiotic use, were analyzed.
RESULTS: Among 257 infants admitted for bronchiolitis, sepsis incidence remained low (8% vs. 7%). Implementation of the guidelines led to a significant reduction in additional diagnostic tests (65% vs. 49%, p = 0.013). Antibiotic prescription rates were unchanged, but a narrower spectrum of antibiotics was observed, with decreased amoxicillin/clavulanate use and increased amoxicillin prescriptions. Lung infections were the most frequent bacterial co-infections, with no rise in bacterial infection rates.
CONCLUSIONS: Implementation of updated guidelines reduced unnecessary diagnostic tests and promoted narrower-spectrum antibiotic use without increasing sepsis incidence. These findings highlight the potential of evidence-based guidelines to optimize care, support antibiotic stewardship, and minimize unnecessary interventions in pediatric critical care.
OBJECTIVES: This study evaluated the impact of updated bronchiolitis management guidelines on sepsis incidence, diagnostic test use, and antibiotic prescriptions in a single center.
METHODS AND SETTINGS: A retrospective study compared two epidemic periods (2022-2023 and 2023-2024) at the PICU, Necker-Enfants Malades Hospital. Clinical and microbiological data, including sepsis incidence, bacterial co-infections, diagnostic tests, and antibiotic use, were analyzed.
RESULTS: Among 257 infants admitted for bronchiolitis, sepsis incidence remained low (8% vs. 7%). Implementation of the guidelines led to a significant reduction in additional diagnostic tests (65% vs. 49%, p = 0.013). Antibiotic prescription rates were unchanged, but a narrower spectrum of antibiotics was observed, with decreased amoxicillin/clavulanate use and increased amoxicillin prescriptions. Lung infections were the most frequent bacterial co-infections, with no rise in bacterial infection rates.
CONCLUSIONS: Implementation of updated guidelines reduced unnecessary diagnostic tests and promoted narrower-spectrum antibiotic use without increasing sepsis incidence. These findings highlight the potential of evidence-based guidelines to optimize care, support antibiotic stewardship, and minimize unnecessary interventions in pediatric critical care.