{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:17:49Z","timestamp":1788337069119,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009139","name":"German Center for Infection Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"publisher"}]},{"name":"German Society for Paediatric Infectious Diseases"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Central nervous system (CNS) infections in children require rapid diagnostic evaluation and prompt empiric antimicrobial therapy. However, clinical presentation is often non-specific, leading to frequent use of broad-spectrum antibiotics while awaiting cerebrospinal fluid (CSF) results. We evaluated antibiotic treatment modifications during the diagnostic work-up and quantified changes in antibiotic spectrum coverage (ASC) before and after lumbar puncture (LP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We conducted a retrospective single-centre study including children &amp;lt;18\u2005years who underwent LP for suspected CNS infection between January 2016 and December 2024. CSF was analysed using the BioFire\u00ae FilmArray\u00ae Meningitis\/Encephalitis (ME) Panel. Antibiotic treatment modifications after LP-related diagnostic information became available were assessed descriptively. Paired ASC scores before and after LP were compared using the Wilcoxon signed-rank test among treated children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1198 children undergoing LP, 730 (60.9%) received antibiotic therapy. Antibiotic use was highest in neonates (227\/246; 92.3%) and infants aged 29\u2005days to &amp;lt;6\u2005months (118\/140; 84.3%) and lowest in adolescents (106\/329; 32.2%). Treatment was modified after LP-related diagnostic information became available in 412\/1198 children (34.4%). Among treated children, 313 (42.9%) underwent de-escalation, 99 (13.6%) escalation and 318 (43.6%) had no change. Overall, mean ASC decreased from 8.5 before LP to 6.6 afterwards (\u0394ASC \u22121.9; P\u200a&amp;lt;\u200a0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LP-related diagnostic information was associated with frequent antibiotic treatment modification and reduced antibiotic spectrum coverage. These findings support integrated CSF diagnostics, including multiplex polymerase chain reaction, as a component of antimicrobial stewardship in children with suspected CNS infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlag199","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:43:33Z","timestamp":1788335013000},"source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic use in children with suspected CNS infection in the molecular diagnostic era: a cohort study of 1198 children"],"prefix":"10.1093","volume":"8","author":[{"given":"Yannik","family":"Vollmuth","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]},{"name":"German Center for Infection Research (DZIF), Partner Site Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Baalmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Soric","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Behrends","sequence":"additional","affiliation":[{"name":"German Center for Infection Research (DZIF), Partner Site Munich , Munich ,","place":["Germany"]},{"name":"Children's Hospital, School of Medicine, Technical University of Munich , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Meyer-B\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0956-0445","authenticated-orcid":false,"given":"Christoph","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]},{"name":"German Center for Infection Research (DZIF), Partner Site Munich , Munich ,","place":["Germany"]},{"name":"German Center for Child and Adolescent Health (DZKJ) , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"H\u00fcbner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Dobler","sequence":"additional","affiliation":[{"name":"German Center for Infection Research (DZIF), Partner Site Munich , Munich ,","place":["Germany"]},{"name":"National TBEV Consultant Laboratory, Bundeswehr Institute of Microbiology , Munich 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