PMID- 32020860
OWN - NLM
STAT- MEDLINE
DCOM- 20210312
LR  - 20231113
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Feb 5
TI  - Comparison of antibiotic and acyclovir usage before and after the implementation 
      of an on-site FilmArray meningitis/encephalitis panel in an academic tertiary 
      pediatric hospital: a retrospective observational study.
PG  - 56
LID - 10.1186/s12887-020-1944-2 [doi]
LID - 56
AB  - BACKGROUND: Prompt initiation of empiric therapy is common practice in case of 
      suspected meningitis or encephalitis. However, in children the most common 
      pathogens are viruses that usually do not require and are not covered by the 
      applied anti-infective treatment. Novel multiplex PCR (mPCR) panels provide rapid 
      on-site diagnostic testing for a variety of pathogens. This study compared 
      empiric antibiotic and acyclovir usage before and after the introduction of an 
      on-site FilmArray Meningitis/Encephalitis Panel (FA ME Panel). METHODS: We 
      retrospectively compared data for empiric antibiotic and acyclovir usage between 
      pediatric patients with suspected central nervous system (CNS) infection 
      receiving mPCR testing and a matched historical control group. Patients were 
      matched by age and suspected CNS infection. We included all patients for whom 
      empiric antibiotics and/or acyclovir were prescribed. RESULTS: Each study group 
      consisted of 46 patients with 29 (63.0%) infants and 17 (37.0%) older children. A 
      viral pathogen was diagnosed in 5/46 (10.9%) patients in the control group (all 
      enteroviruses) and in 14/46 (30.4%) patients in the mPCR group (enterovirus 
      n = 9; human herpesvirus 6 (HHV-6) n = 5), (p = 0.038)). Length of Therapy (LoT) 
      and Days of Therapy (DoT) for antibiotics were significantly lower for infants 
      (4.0 vs. 3.0, p = 0.038 and 8.0 vs. 6.0, p = 0.015, respectively). Acyclovir 
      therapy was significantly shorter for both, infants and older children (3.0 vs. 
      1.0 day, p < 0.001 for both age groups). CONCLUSION: The findings of our study 
      suggest that the introduction of a FA ME Panel into clinical routine procedures 
      is associated with a significantly reduced LoT and DoT of empiric anti-infective 
      treatment in children with suspected meningoencephalitis. The largest effect was 
      observed in infants.
FAU - Hagen, Alexandra
AU  - Hagen A
AD  - Division of Pediatric Infectious Disease, Hauner Children's Hospital, University 
      of Munich (LMU), Lindwurmstrasse 4, 80337, Munich, Germany.
FAU - Eichinger, Anna
AU  - Eichinger A
AD  - Division of Pediatric Infectious Disease, Hauner Children's Hospital, University 
      of Munich (LMU), Lindwurmstrasse 4, 80337, Munich, Germany.
FAU - Meyer-Buehn, Melanie
AU  - Meyer-Buehn M
AD  - Division of Pediatric Infectious Disease, Hauner Children's Hospital, University 
      of Munich (LMU), Lindwurmstrasse 4, 80337, Munich, Germany.
FAU - Schober, Tilmann
AU  - Schober T
AD  - Division of Pediatric Infectious Disease, Hauner Children's Hospital, University 
      of Munich (LMU), Lindwurmstrasse 4, 80337, Munich, Germany.
FAU - Huebner, Johannes
AU  - Huebner J
AUID- ORCID: 0000-0003-1232-4646
AD  - Division of Pediatric Infectious Disease, Hauner Children's Hospital, University 
      of Munich (LMU), Lindwurmstrasse 4, 80337, Munich, Germany. 
      johannes.huebner@med.uni-muenchen.de.
LA  - eng
PT  - Journal Article
DEP - 20200205
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - 0 (Anti-Bacterial Agents)
RN  - X4HES1O11F (Acyclovir)
SB  - IM
MH  - *Acyclovir/therapeutic use
MH  - Adolescent
MH  - *Anti-Bacterial Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - *Encephalitis/drug therapy
MH  - Female
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Infant
MH  - Male
MH  - *Meningitis/drug therapy
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC7001287
OTO - NOTNLM
OT  - Antimicrobial stewardship
OT  - Encephalitis
OT  - FilmArray
OT  - Meningitis
OT  - Meningoencephalitis
OT  - mPCR
COIS- JH has received speaker fees and MMB has been invited to a seminar by BioMerieux, 
      the other authors declare that they have no conflict of interest.
EDAT- 2020/02/06 06:00
MHDA- 2021/03/13 06:00
PMCR- 2020/02/05
CRDT- 2020/02/06 06:00
PHST- 2019/06/01 00:00 [received]
PHST- 2020/01/23 00:00 [accepted]
PHST- 2020/02/06 06:00 [entrez]
PHST- 2020/02/06 06:00 [pubmed]
PHST- 2021/03/13 06:00 [medline]
PHST- 2020/02/05 00:00 [pmc-release]
AID - 10.1186/s12887-020-1944-2 [pii]
AID - 1944 [pii]
AID - 10.1186/s12887-020-1944-2 [doi]
PST - epublish
SO  - BMC Pediatr. 2020 Feb 5;20(1):56. doi: 10.1186/s12887-020-1944-2.