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Community-acquired pneumonia in paediatric

Lesley J Scott
Intravenous ceftaroline fosamil (Zinforo™), a prodrug that is rapidly converted to its active metabolite ceftaroline, is approved for use in adults and children (from 2 months of age) with complicated skin and soft tissue infections (cSSTIs) or community-acquired pneumonia (CAP). In several multinational trials, ceftaroline fosamil was an effective and generally well tolerated treatment in adult and paediatric patients with cSSTIs or CAP. In the phase 3 CANVAS trials, ceftaroline fosamil treatment was noninferior to vancomycin plus aztreonam in adults with cSSTIs...
October 20, 2016: Drugs
Francesco Blasi, Murat Akova, Paolo Bonanni, Nathalie Dartois, Evelyne Sauty, Chris Webber, Antoni Torres
Pneumococcal pneumonia remains a clear unmet medical need for adults worldwide. Despite advances in vaccine technology, vaccination coverage remains low, putting many people at risk of significant morbidity and mortality. The herd effect seen with paediatric vaccination is not enough to protect all older and vulnerable people in the community, and more needs to be done to increase the uptake of pneumococcal vaccination in adults. Several key groups are at increased risk of contracting pneumococcal pneumonia, and eligible patients are being missed in clinical practice...
October 15, 2016: European Journal of Internal Medicine
Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Tessa R Davis, Hannah R Evans, Jennifer Murtas, Aimee Weisman, J Lynn Francis, Ahmed Khan
AIM: The aim of the study was to assess the utility of blood cultures in children admitted to hospital with community-acquired pneumonia. The primary outcome was the number of positive blood culture results, and secondary outcomes included the effect of positive blood culture results on management, and the identification of other clinical/biochemical variables that could predict blood culture results or the course of illness. METHODS: A retrospective data analysis was carried out on all children admitted to Gosford Hospital during the 2-year period from July 2013 to June 2015...
October 7, 2016: Journal of Paediatrics and Child Health
Elise Launay, Karine Levieux, Corinne Levy, François Dubos, Alain Martinot, Bénédicte Vrignaud, Flora Lepage, Robert Cohen, Emmanuel Grimprel, Matthieu Hanf, François Angoulvant, Christèle Gras-Le Guen
BACKGROUND: Lower respiratory tract infection is a common cause of consultation and antibiotic prescription in paediatric practice. The misuse of antibiotics is a major cause of the emergence of multidrug-resistant bacteria. The aim of this study was to evaluate the frequency, changes over time, and determinants of non-compliance with antibiotic prescription recommendations for children admitted in paediatric emergency department (PED) with community-acquired pneumonia (CAP). METHODS: We conducted a prospective two-period study using data from the French pneumonia network that included all children with CAP, aged one month to 15 years old, admitted to one of the ten participating paediatric emergency departments...
2016: BMC Pediatrics
A Nor Azizah, M N Fadzilah, M Mariam, Z A Anis Siham, A Ariza, M N Noor Shafina, A Anita Kaur
INTRODUCTION: bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens. METHOD: A retrospective study was conducted by analysing clinical details, blood cultures and antimicrobial susceptibility testing results in children between the ages of 0 to 13 years old, who were admitted to selayang Hospital over an 11-year period from 2001 until 2011...
June 2016: Medical Journal of Malaysia
Karimeldin Ma Salih, Jalal Ali Bilal, Widad Eldouch, Ali Abdin
INTRODUCTION: Pneumonia is common presentation in the emergency room and is still a cause of morbidity and mortality. The rationale of this study was to test the trend of paediatricians to achieve rapid response facing severe pneumonia, the lack of agreed on plan for the management of community acquired pneumonia (CAP) and the few experiences regarding injectable form of β-lactam antimicrobial. MATERIALS AND METHODS: This is a prospective case control study, purposive randomized sampling, three patients were excluded since their information was incomplete, 132 patients were randomly divided into groups, one group named control group (penicillin according to the guidelines of WHO 2013), 33 patients; second group treated by β-lactam inhibitors (Augmentin IV) 50 patients; and third group treated by 3(rd) generation cephalosporin (ceftriaxone) 49 patients...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Laura Folgori, Julia Bielicki, Beatriz Ruiz, Mark A Turner, John S Bradley, Daniel K Benjamin, Theoklis E Zaoutis, Irja Lutsar, Carlo Giaquinto, Paolo Rossi, Mike Sharland
There is no global consensus on the conduct of clinical trials in children and neonates with complicated clinical infection syndromes. No comprehensive regulatory guidance exists for the design of antibiotic clinical trials in neonates and children. We did a systematic review of antibiotic clinical trials in complicated clinical infection syndromes (including bloodstream infections and community-acquired pneumonia) in children and neonates (0-18 years) to assess whether standardised European Medicines Agency (EMA) and US Food and Drug Administration (FDA) guidance for adults was used in paediatrics, and whether paediatric clinical trials applied consistent definitions for eligibility and outcomes...
September 2016: Lancet Infectious Diseases
Steven McVea, Andrew James Thompson, Noina Abid, Julie Richardson
A 13-year-old boy with a background of Prader-Willi syndrome (PWS) was admitted to the regional paediatric intensive care unit, with community-acquired pneumonia. Despite a week of intravenous antibiotics, resolution of inflammatory markers and resolving consolidation on radiograph, he remained feverish. Fever of unknown origin investigations were negative and he was diagnosed with central thermal dysregulation secondary to hypothalamic dysfunction in PWS. Following a hyperpyrexia period, secondary rhabdomyolysis and renal failure developed...
2016: BMJ Case Reports
George A Syrogiannopoulos, Aspasia N Michoula, Georgios Tsimitselis, Katerina Vassiou, Denise C Chryssanthopoulou, Ioanna N Grivea
BACKGROUND: Parapneumonic effusions in children are usually associated with pneumococcal infections. In Greece, the 7-valent pneumococcal conjugate vaccine was replaced by higher-valent pneumococcal conjugate vaccines (PCVs); 10-valent was introduced in May 2009 and 13-valent (PCV13) in June 2010. Since July 2010, PCV13 has been the most commonly used PCV. In a study conducted at the University General Hospital of Larissa, Central Greece, from January 2012 to January 2016, 85.7% of children born after the implementation of PCV13 and aged 24-59 months had received the complete series (3 + 1 immunization schedule) of PCV13...
October 2016: Infectious Diseases
Antonio Torres, Johan Willem Mouton, Federico Pea
Hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP) are among the most common infections treated in the hospital setting, and together they place a significant burden on healthcare systems. Successful management of HAP and CAP depends on rapid initiation of empirical antibiotic therapy with broad-spectrum antibiotics. Ceftobiprole is a new-generation, broad-spectrum cephalosporin antibiotic for the treatment of HAP (excluding ventilator-associated pneumonia) and CAP. It displays potent in vitro activity against a broad range of pathogens important in pneumonia...
June 7, 2016: Clinical Pharmacokinetics
Michael Burk, Karim El-Kersh, Mohamed Saad, Timothy Wiemken, Julio Ramirez, Rodrigo Cavallazzi
The advent of PCR has improved the identification of viruses in patients with community-acquired pneumonia (CAP). Several studies have used PCR to establish the importance of viruses in the aetiology of CAP.We performed a systematic review and meta-analysis of the studies that reported the proportion of viral infection detected via PCR in patients with CAP. We excluded studies with paediatric populations. The primary outcome was the proportion of patients with viral infection. The secondary outcome was short-term mortality...
June 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Merijn W Bijlsma, Matthijs C Brouwer, E Soemirien Kasanmoentalib, Anne T Kloek, Marjolein J Lucas, Michael W Tanck, Arie van der Ende, Diederik van de Beek
BACKGROUND: We studied causative pathogens, clinical characteristics, and outcome of adult community-acquired bacterial meningitis after the introduction of adjunctive dexamethasone treatment and nationwide implementation of paediatric conjugate vaccines. METHODS: In this cohort study, we prospectively assessed adults (age >16 years) with community-acquired bacterial meningitis in the Netherlands, identified through the National Reference Laboratory for Bacterial Meningitis or individual physicians between Jan 1, 2006, and July 1, 2014...
March 2016: Lancet Infectious Diseases
Michael J Smith, Jeffrey S Gerber, Adam L Hersh
BACKGROUND: The clinical and economic outcomes associated with pediatric antimicrobial stewardship programs (ASPs) and other supplemental antimicrobial stewardship (AS) interventions have not been well described or reviewed. METHODS: We performed a systematic review using PubMed to identify studies with any of the following terms in the title or abstract: "antimicrobial stewardship," "antimicrobial control," "antibiotic control," or "antibiotic stewardship." Studies were further limited to inpatient studies in the United States that contained the terms: "child," "children," "pediatric*" ("*" includes all terms with the same stem), "paediatric,*" "newborn," "infant," or "neonat,*" in the title or abstract...
December 2015: Journal of the Pediatric Infectious Diseases Society
Marie-Josée J Mangen, Mark H Rozenbaum, Susanne M Huijts, Cornelis H van Werkhoven, Douwe F Postma, Mark Atwood, Anna M M van Deursen, Arie van der Ende, Diederick E Grobbee, Elisabeth A M Sanders, Reiko Sato, Theo J M Verheij, Conrad E Vissink, Marc J M Bonten, G Ardine de Wit
The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) demonstrated the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) in preventing vaccine-type community-acquired pneumonia and vaccine-type invasive pneumococcal disease in elderly subjects. We examined the cost-effectiveness of PCV13 vaccination in the Netherlands. Using a Markov-type model, incremental cost-effectiveness ratios (ICER) of PCV13 vaccination in different age- and risk-groups for pneumococcal disease were evaluated using a societal perspective...
November 2015: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Cameron Burton, Tony Walls, Neil Price, Tamsin Glasgow, Cameron Walker, Spencer Beasley, Emma Best
AIMS: We aimed to identify the causative organisms and sensitivities in community-acquired paediatric empyema at Starship Children's Hospital and Christchurch Hospital and to determine if current antibiotic recommendations are appropriate. METHODS: Retrospective analysis was undertaken of all cases with clinical, radiological, and microbiological evidence of empyema at Starship Children's Hospital and Christchurch Hospital between June 2009 and March 2013 (3.8 years), and January 2009 and May 2014 (5...
May 29, 2015: New Zealand Medical Journal
Joachim Luthander, Rutger Bennet, Christian G Giske, Anna Nilsson, Margareta Eriksson
AIM: This study explored the incidence and aetiology of bloodstream infections after patients received the pneumococcal conjugate vaccination and a risk-based intrapartum antibiotic prophylaxis against early onset sepsis caused by group B streptococcus. We also monitored clinically relevant antimicrobial resistance. METHOD: We studied 3986 positive blood cultures from children up to 17 years of age at a paediatric hospital in Stockholm, Sweden, using data from medical records before and after the initiatives, to reduce early onset sepsis, were introduced in 2007 and 2008...
September 2015: Acta Paediatrica
Angela Dramowski, Mark F Cotton, Helena Rabie, Andrew Whitelaw
BACKGROUND: The epidemiology of paediatric bloodstream infection (BSI) in Sub-Saharan Africa is poorly documented with limited data on hospital-acquired sepsis, impact of HIV infection, BSI trends and antimicrobial resistance. METHODS: We retrospectively reviewed paediatric BSI (0-14 years) at Tygerberg Children's Hospital between 1 January 2008 and 31 December 2013 (excluding neonatal wards). Laboratory and hospital data were used to determine BSI rates, blood culture contamination, pathogen profile, patient demographics, antimicrobial resistance and factors associated with mortality...
2015: BMC Pediatrics
D Moreno-Pérez, A Andrés Martín, A Tagarro García, A Escribano Montaner, J Figuerola Mulet, J J García García, A Moreno-Galdó, C Rodrigo Gonzalo de Lliria, J Saavedra Lozano
The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence...
September 2015: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Min Wang, Feng Cai, Xiaodong Wu, Ting Wu, Xin Su, Yi Shi
Several studies examining the incidence of viral infection in childhood community-acquired pneumonia (CAP) utilizing polymerase chain reaction (PCR) or real-time PCR methods have been reported. We systematically searched Pubmed and Embase for studies reporting the incidence of respiratory viral infection in childhood CAP. The pooled incidences of viral infection were calculated with a random-effects model. Sources of heterogeneity were explored by subgroup analysis and a univariant metaregression analysis. We included 21 eligible reports in our study...
April 2015: Respirology: Official Journal of the Asian Pacific Society of Respirology
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