Antibiotic use for respiratory syncytial virus in the Middle East: A surveillance study in hospitalized Jordanian children
In developing countries where point-of-care testing is limited, providers rely on clinical judgement to discriminate between viral and bacterial respiratory infections. We performed a cross-sectional cohort study of hospitalized Jordanian children to evaluate antibiotic use for respiratory syncytial...
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| Vydané v: | PloS one Ročník 16; číslo 11; s. e0260473 |
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| Hlavní autori: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
United States
Public Library of Science
29.11.2021
Public Library of Science (PLoS) |
| Predmet: | |
| ISSN: | 1932-6203, 1932-6203 |
| On-line prístup: | Získať plný text |
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| Shrnutí: | In developing countries where point-of-care testing is limited, providers rely on clinical judgement to discriminate between viral and bacterial respiratory infections. We performed a cross-sectional cohort study of hospitalized Jordanian children to evaluate antibiotic use for respiratory syncytial virus (RSV) infections.
Admitting diagnoses from a prior viral surveillance cohort of hospitalized Jordanian children were dichotomized into suspected viral-like, non-pulmonary bacterial-like, and pulmonary bacterial-like infection. Stratifying by sex, we performed a polytomous logistic regression adjusting for age, underlying medical condition, maternal education, and region of residence to estimate prevalence odds ratios (PORs) for antibiotic use during hospitalization. Sensitivity and specificity of admission diagnoses and research laboratory results were compared.
Children with a suspected viral-like admission diagnosis, compared to those with suspected non-pulmonary bacterial-like, were 88% and 86% less likely to be administered an empiric/first-line antibiotic (male, aPOR: 0.12; female, aPOR: 0.14; p-value = <0.001). There were slight differences by sex with males having a lower prevalence than females in being administered an expanded coverage antibiotic; but they had a higher prevalence of macrolide administration than males with non-pulmonary bacterial-like infection. Overall, children with RSV had a 34% probability (sensitivity) of being assigned to a suspected viral-like diagnosis; whereas RSV-negative children had a 76% probability (specificity) of being assigned to a suspected pulmonary bacterial-like diagnosis.
Hospitalized children with a suspected viral-like admission diagnosis were less likely to receive an empiric/first-line and expanded coverage antibiotic compared to suspected non-pulmonary and pulmonary infections; however, when evaluating the accuracy of admission diagnosis to RSV-laboratory results there were considerable misclassifications. These results highlight the need for developing antibiotic interventions for Jordan and the rest of the Middle East. |
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| Bibliografia: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: Natasha Halasa, MD, MPH receives grant support from Sanofi, Quidel, and speaker compensation from an education grant supported by Genentech. Sanofi also donated vaccines and influenza antibody testing for influenza vaccine trial. John Williams, MD is on the scientific board for Quidel, Independent Data Safely Monitoring Committee, GlaxoSmithKline, scientific advisory board ID Connect. All of the other authors declare no competing interests. These conflicts do not alter our adherence to PLOS ONE policies on sharing data and materials. These authors are joint senior authors on this work. |
| ISSN: | 1932-6203 1932-6203 |
| DOI: | 10.1371/journal.pone.0260473 |