{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:53:15Z","timestamp":1793328795367,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12-HS026393"],"award-info":[{"award-number":["K12-HS026393"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32AI052071"],"award-info":[{"award-number":["T32AI052071"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antibiotics are prescribed to most pediatric intensive care unit (PICU) patients, but data describing indications and appropriateness of antibiotic orders in this population are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a multicenter point prevalence study that included children admitted to 10 geographically diverse PICUs over 4 study days in 2019. Antibiotic orders were reviewed for indication, and appropriateness was assessed using a standardized rubric.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1462 patients admitted to participating PICUs, 843 (58%) had at least 1 antibiotic order. A total of 1277 antibiotic orders were reviewed. Common indications were empiric therapy for suspected bacterial infections without sepsis or septic shock (260 orders, 21%), nonoperative prophylaxis (164 orders, 13%), empiric therapy for sepsis or septic shock (155 orders, 12%), community-acquired pneumonia (CAP; 118 orders, 9%), and post-operative prophylaxis (94 orders, 8%). Appropriateness was assessed for 985 orders for which an evidence-based rubric for appropriateness could be created. Of these, 331 (34%) were classified as inappropriate. Indications with the most orders classified as inappropriate were empiric therapy for suspected bacterial infection without sepsis or septic shock (78 orders, 24%), sepsis or septic shock (55 orders, 17%), CAP (51 orders, 15%), ventilator-associated infections (47 orders, 14%), and post-operative prophylaxis (44 orders, 14%). The proportion of antibiotics classified as inappropriate varied across institutions (range, 19%\u201343%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most PICU patients receive antibiotics. Based on our study, we estimate that one-third of antibiotic orders are inappropriate. Improved antibiotic stewardship and research focused on strategies to optimize antibiotic use in critically ill children are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac698","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T16:44:39Z","timestamp":1661877879000},"page":"e1021-e1030","source":"Crossref","is-referenced-by-count":28,"title":["Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10-Center Point Prevalence Study"],"prefix":"10.1093","volume":"76","author":[{"given":"Kathleen","family":"Chiotos","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Perelman School of Medicine, University 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Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika L","family":"Stalets","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica H","family":"Rubens","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranita D","family":"Tamma","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie S","family":"Cabler","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Washington University in St. Louis , St. Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Newland","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Washington University in St. Louis , St. Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Crandall","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Primary Children's Hospital , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Berkman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine , Seattle, Washington , 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