@article{3101544,
    title = "Variation in paediatric hospital antibiotic guidelines in Europe",
    author = "Spyridis, N. and Syridou, G. and Goossens, H. and Versporten, A. and Kopsidas, J. and Kourlaba, G. and Bielicki, J. and Drapier, N. and Zaoutis, T. and Tsolia, M. and Sharland, M. and Vergison, A. and Léon, V. and Delestrait, M. and Huza, C. and Lepage, P. and Mahieu, L. and Boy, T. and Jansens, H. and Van Der Linden, D. and Briquet, C. and Allegaert, K. and Smits, A. and Gabriels, P. and Vuye, A. and Lutsar, I. and Tamm, E. and Larionova, A. and Laan, D. and Orbach, M. and Lorrot, M. and Angoulvant, F. and Prot-Labarthe, S. and Dubos, F. and Lagree, M. and Hufnagel, M. and Schuster, K. and Henneke, P. and Roilides, E. and Iosifidis, E. and Corovessi, V. and Michos, A. and Galanakis, E. and Gkentzi, D. and Giacquinto, C. and Longo, G. and Dona, D. and Mion, T. and D'Argenio, P. and Degli, M.L.C. and De Luca, M. and Ciliento, G. and Esposito, S. and Danieli, E. and Montinaro, V. and Tenconi, R. and Nicolini, G. and Sviestina, C.I.M. and Pavare, J. and Rasnaca, K. and Gardovska, D. and Usonis, V. and Grope, I. and Gurksniene, V. and Eidukaite, A. and Biver, A. and Brett, A. and Esteves, I. and Cambrea, S.C. and Craiu, M. and Tomescu, E. and Cizman, M. and Babnik, J. and Kenda, R. and Vidmar, I. and Nunez-Cuadros, E. and Rojo, P. and Lopez-Varela, E. and Ureta, N. and Perez-Lopez, A. and Mosqueda, R. and Orta, L. and Santos, M. and Navarro, M. and Santiago, B. and Hernandez-Sampelaya, T. and Saavedra, J. and Pineiro, R. and Torel, P. and Cano, I.M. and Baumann, P. and Berger, C. and Menson, E. and Botgros, A. and Doerholt, K. and Drysdale, S. and Makwana, N. and McCorry, A. and Garbash, E.M. and Chetcutiganado, C. and McLeod, M. and Caldwell, N. and Nash, C. and McCullagh, B. and Sharpe, D. and Tweddell, L. and Liese, J.G. and Aston, J. and Gallagher, A. and Satodia, P. and Howard-Smith, N. and Korinteli, I. and Tavchioska, G. and Jensen, L. and Trethon, A. and Unuk, S. and Childs, N. and Canlas, J.",
    journal = "Archives of Disease in Childhood",
    year = "2016",
    volume = "101",
    number = "1",
    pages = "72-76",
    publisher = "BMJ Publishing Group",
    issn = "0003-9888, 1468-2044",
    doi = "10.1136/archdischild-2015-308255",
    keywords = "amoxicillin;  antibiotic agent;  cephalosporin;  penicillin derivative;  antiinfective agent, antibiotic therapy;  Article;  bone infection;  child;  childhood disease;  Europe;  health care quality;  human;  infant;  infection;  newborn sepsis;  pediatric hospital;  practice guideline;  priority journal;  respiratory tract infection;  skin infection;  soft tissue infection;  treatment duration;  urinary tract infection;  Bacterial Infections;  clinical practice;  clinical trial;  cross-sectional study;  drug administration;  hospital;  multicenter study;  newborn;  practice guideline;  preschool child;  prescription;  Respiratory Tract Infections;  sepsis;  standards;  statistics and numerical data;  Urinary Tract Infections, Anti-Bacterial Agents;  Bacterial Infections;  Child;  Child, Preschool;  Cross-Sectional Studies;  Drug Administration Schedule;  Drug Prescriptions;  Europe;  Hospitals, Pediatric;  Humans;  Infant;  Infant, Newborn;  Practice Guidelines as Topic;  Practice Patterns, Physicians';  Respiratory Tract Infections;  Sepsis;  Urinary Tract Infections",
    abstract = "Objective: To assess the availability and source of guidelines for common infections in European paediatric hospitals and determine their content and characteristics. Design: Participating hospitals completed an online questionnaire on the availability and characteristics of antibiotic prescribing guidelines and on empirical antibiotic treatment including duration of therapy for 5 common infection syndromes: respiratory tract, urinary tract, skin and soft tissue, osteoarticular and sepsis in neonates and children. Results: 84 hospitals from 19 European countries participated in the survey of which 74 confirmed the existence of guidelines. Complete guidelines (existing guidelines for all requested infection syndromes) were reported by 20% of hospitals and the majority (71%) used a range of different sources. Guidelines most commonly available were those for urinary tract infection (UTI) (74%), neonatal sepsis (71%) and sepsis in children (65%). Penicillin and amoxicillin were the antibiotics most commonly recommended for respiratory tract infections (RTIs) (up to 76%), cephalosporin for UTI (up to 50%) and for skin and soft tissue infection (SSTI) and bone infection (20% and 30%, respectively). Antistaphylococcal penicillins were recommended for SSTIs and bone infections in 43% and 36%, respectively. Recommendations for neonatal sepsis included 20 different antibiotic combinations. Duration of therapy guidelines was mostly available for RTI and UTI (82%). A third of hospitals with guidelines for sepsis provided recommendations for length of therapy. Conclusions: Comprehensive antibiotic guideline recommendations are generally lacking from European paediatric hospitals. We documented multiple antibiotics and combinations for most infections. Considerable improvement in the quality of guidelines and their evidence base is required, linking empirical therapy to resistance rates."
}