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The aims of this study were to assess compliance with antibiotic recommendations and factors associated with non-compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational study in eight French Paediatric and Neonatal ICUs with an antimicrobial stewardship programme (ASP) organised once a week for the most part. All children receiving antibiotics for a suspected or proven BI were evaluated. Newborns\u2009&lt;\u200972\u00a0h old, neonates\u2009&lt;\u200937 weeks, age\u2009\u2265\u200918 years and children under surgical antimicrobial prophylaxis were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      139 suspected (or proven) BI episodes in 134 children were prospectively included during six separate time-periods over one year. The final diagnosis was 26.6% with no BI, 40.3% presumed (i.e., not documented) BI and 35.3% documented BI. Non-compliance with antibiotic recommendations occurred in 51.1%. The main reasons for non-compliance were inappropriate choice of antimicrobials (27.3%), duration of one or more antimicrobials (26.3%) and length of antibiotic therapy (18.0%). In multivariate analyses, the main independent risk factors for non-compliance were prescribing\u2009\u2265\u20092 antibiotics (OR 4.06, 95%CI 1.69\u20139.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0017), duration of broad-spectrum antibiotic therapy\u2009\u2265\u20094 days (OR 2.59, 95%CI 1.16\u20135.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0199), neurologic compromise at ICU admission (OR 3.41, 95%CI 1.04\u201311.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0431), suspected catheter-related bacteraemia (ORs 3.70 and 5.42, 95%CIs 1.32 to 15.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.02), a BI site classified as \u201cother\u201d (ORs 3.29 and 15.88, 95%CIs 1.16 to 104.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.03), sepsis with \u2265\u20092 organ dysfunctions (OR 4.21, 95%CI 1.42\u201312.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0098), late-onset ventilator-associated pneumonia (OR 6.30, 95%CI 1.15\u201334.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0338) and \u2265\u20091 risk factor for extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae (OR 2.56, 95%CI 1.07\u20136.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0353). Main independent factors for compliance were using antibiotic therapy protocols (OR 0.42, 95%CI 0.19\u20130.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0313), respiratory failure at ICU admission (OR 0.36, 95%CI 0.14\u20130.90,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0281) and aspiration pneumonia (OR 0.37, 95%CI 0.14\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0486).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Half of antibiotic prescriptions remain non-compliant with guidelines. Intensivists should reassess on a day-to-day basis the benefit of using several antimicrobials or any broad-spectrum antibiotics and stop antibiotics that are no longer indicated. Developing consensus about treating specific illnesses and using department protocols seem necessary to reduce non-compliance. A daily ASP could also improve compliance in these situations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov: number NCT04642560. The date of first trial registration was 24\/11\/2020.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-09472-0","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T16:17:51Z","timestamp":1718209071000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Compliance with antibiotic therapy guidelines in french paediatric intensive care units: a multicentre observational study"],"prefix":"10.1186","volume":"24","author":[{"given":"Romain","family":"Amadieu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Brehin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ad\u00e9la","family":"Chahine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erick","family":"Grouteau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Dubois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Munzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Flumian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Brissaud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Ros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gael","family":"Jean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Brotelande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Travert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Savy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benoit","family":"Boeuf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghida","family":"Ghostine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Popov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Duport","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Wolff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laure","family":"Maurice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane","family":"Dauger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Breinig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"9472_CR1","doi-asserted-by":"publisher","first-page":"e172352","DOI":"10.1001\/jamapediatrics.2017.2352","volume":"171","author":"TJ Matics","year":"2017","unstructured":"Matics TJ, Sanchez-Pinto LN. 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BMC Infect Dis. 2022;22:420.","journal-title":"BMC Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09472-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09472-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09472-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T04:02:31Z","timestamp":1718251351000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09472-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,12]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9472"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09472-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3143698\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,12]]},"assertion":[{"value":"5 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Strict confidentiality was ensured at all times during data collection, storage and analysis. All methods were carried out in accordance with relevant guidelines and regulations. According to French Ethics and Regulatory Law (Public Health Code), studies based on the exploitation of usual care data should not be submitted to an Ethics Committee but must be declared or covered by reference methodology from the French Data Protection Commission (CNIL). Toulouse University Hospital signed a commitment of compliance with reference methodology MR-004 from the CNIL. After evaluation and validation by the data protection officer and according to General Data Protection Regulations, this study met all of the criteria and is registered on the Toulouse University Hospital Study Data Register (register number: RnIPH2019-79) and covered by MR-004 (CNIL number: 2206723 v 0). This study was approved by Toulouse University Hospital and we confirm that the ethics requirements were fully complied with in the above report. For clinical trials covered by reference methodology MR-004, informed written consent is not required. Informed verbal consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"582"}}