{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:58:09Z","timestamp":1790913489189,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":348,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In pediatric sepsis, the source of infection remains unidentified in approximately 16% of cases, and causative microorganisms are not isolated in 35% of cases, potentially due to non\u2010infectious etiologies or false\u2010negative culture results. Although a 7\u2010 to 10\u2010day antimicrobial regimen is commonly used for culture\u2010negative sepsis (CNS), robust evidence supporting this practice is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included congenital heart disease patients aged &lt;5\u2009years who were admitted to a pediatric intensive care unit between April 2022 and March 2024, diagnosed with sepsis, and those who exhibited negative culture results, but received antimicrobial therapy for at least 7\u2009days. Descriptive epidemiological analysis was conducted on antimicrobial use in the CNS and instances of antimicrobial re\u2010administration within 1 month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen cases were analyzed, with a median age of 1\u2009month. Eleven patients (69%) had received prior antimicrobial therapy within 1 week, primarily for surgical prophylaxis. All blood cultures yielded negative results. Bacterial growth was identified in one urine culture and two sputum cultures; however, these were asymptomatic carriers. The most frequently administered empirical regimens were cefepime combined with vancomycin. Antimicrobial re\u2010administration occurred in five cases (31%), with a median duration of 8\u2009days, and were primarily attributed to device\u2010related infections; however, one case was later diagnosed as mediastinitis. Four patients (25%) died within 1 month, with mortality attributed to underlying conditions, but not to infectious diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A 7\u2010day course of antimicrobials may be sufficient in CNS; however, vigilant monitoring for deep\u2010seated infections is advised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70287","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:20:31Z","timestamp":1765801231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A survey of antimicrobial therapy for culture\u2010negative sepsis in pediatric congenital heart disease patients"],"prefix":"10.1111","volume":"67","author":[{"given":"Eiki","family":"Ogawa","sequence":"first","affiliation":[{"name":"Department of General Pediatrics Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2439-5388","authenticated-orcid":false,"given":"Takanari","family":"Ikeyama","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Aichi Children's Health and Medical Center  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Aichi Children's Health and Medical Center  Aichi 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