Antibiotic Stewardship in Community Hospitals, Respiratory Syncytial Virus Infections
Conditions
Keywords
Respiratory Syncytial Virus Infections, Anti-Bacterial Agents, Health Care Costs, Polymerase Chain Reaction, C-Reactive Protein
Brief summary
This study retrospectively evaluated the clinical, laboratory, and radiologic factors that influence the decision to prescribe antibiotics in children under 2 years of age hospitalized with RSV-positive acute lower respiratory tract infections. The study also examined the economic impact of antibiotic use in these patients. The goal is to improve clinical decision-making and reduce unnecessary antibiotic exposure in children with viral infections.
Detailed description
This retrospective, single-center study aimed to assess the clinical decision-making process regarding antibiotic prescription in children aged 1 to 24 months hospitalized with RSV-positive acute lower respiratory tract infections (ALRTI). The study was conducted at Dr. Behçet Uz Children's Hospital and covered four consecutive RSV seasons (April 2017 - April 2021). RSV infection was confirmed via multiplex PCR. Clinical and laboratory variables potentially influencing antibiotic use included fever, respiratory distress, CRP levels, leukocyte count, and radiologic findings such as infiltrates on chest X-ray. The study also examined whether antibiotic selection (agent, timing, and duration) was associated with specific clinical profiles or severity indicators. Hospitalization cost data were analyzed to estimate the economic burden of antibiotic use in RSV-positive patients. The study contributes to improved antimicrobial stewardship by identifying patterns of potentially unnecessary antibiotic prescriptions in viral respiratory infections. Ethical approval was obtained from the local ethics committee (Approval No: 2021-634), and the study adhered to the principles of the Declaration of Helsinki.
Interventions
None listed
Sponsors
Dr. Behcet Uz Children's Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Months to 24 Months
Healthy volunteers
No
Inclusion criteria
* Age between 1 and 24 months at the time of hospitalization * Laboratory-confirmed RSV positivity via multiplex PCR * Hospitalized for acute lower respiratory tract infection * Complete hospitalization and clinical data available
Exclusion criteria
* Detection of additional respiratory pathogens on multiplex PCR * Discharge against medical advice before treatment was completed * Missing or incomplete key clinical, laboratory, or radiologic data * ICU admission without full follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association between clinical/laboratory/radiologic parameters and antibiotic prescription | During hospitalization (April 2017 - April 2021) | This outcome assesses the relationship between objective findings (e.g., CRP levels, abnormal chest X-ray, fever) and the decision to initiate antibiotic therapy in RSV-positive children aged 1-24 months hospitalized with acute lower respiratory tract infections. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total antibiotic-related hospitalization cost per patient | During hospitalization (April 2017 - April 2021) | This outcome evaluates the economic impact of antibiotic use by calculating the direct hospitalization costs associated with antibiotic treatment in RSV-positive pediatric patients. |
Countries
Turkey (Türkiye)
Outcome results
None listed