Title:The Evaluation of the Impact of Antibiotic De-escalation among Paediatric Patients Admitted to Tertiary Care Hospital in Ajman, UAE: A Cross-sectional Retrospective Observational Study
Volume: 21
Issue: 1
Author(s): Nour Elshaeir and Syed Wasif Gillani*
Affiliation:
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
Keywords:
Antibiotic de-escalation, pediatric patients, tertiary care hospitals, cross-sectional studies, antibiotic therapy, Multidrug- resistant (MDR).
Abstract:
Background: Antibiotic de-escalation therapy plays a vital role in reducing the risk of
bacterial resistance across the globe. This study elucidates the significance, determinants, and outcomes
pertaining to Antibiotic De-escalation (ADE). The ADE is acknowledged as a crucial component
within Antimicrobial Stewardship Programs (ASPs). The proliferation of antimicrobial-resistant
bacteria arises as an anticipated outcome of the extensive utilization of antibiotics, heightening
researchers' apprehensions regarding this global challenge.
Objective: The primary objective of the study was to evaluate the usage of antibiotics in terms of
clinical outcomes (re-admission within 30 days and therapy outcomes upon discharge), adverse
events, duration of de-escalation, and duration of hospitalizations among pediatric patients admitted
to a tertiary care hospital due to various infectious diseases.
Methods: A retrospective study was conducted during a four-month period, from January 2022 to
April 2023, at a tertiary care facility in Ajman, United Arab Emirates. Participants included in this
study were based on specific inclusion and exclusion criteria.
Results: A total of 200 pediatric records were screened. The majority of participants, accounting
for 66.0%, were female, and 54.0% were classified as Arabs in terms of race. The mean age was
7.5 years (± 2.8). The most prevalent symptoms reported were fever (98%), cough (75%), and
sore throat (73%). Male participants were more inclined to present with bacterial infections
(88.2%) compared to viral infections (3.8%), bacterial and viral co-illnesses (2.5%), or parasitic infections
(1.3%) at the time of admission. Regarding clinical outcomes, 27% of patients were readmitted
with the same infection type, while 52% did not experience readmission. The analysis also
included information on the number of patients within each antibiotic therapy duration category,
alongside the mean duration of antibiotic de-escalation in hours with standard deviation (± SD).
The statistical significance of these associations was assessed using P-values, revealing a significant
relationship (P < 0.0001) between the duration of antibiotic therapy and the time required for
antibiotic de-escalation.
Conclusion: The study's analysis revealed that individuals readmitted to the hospital, irrespective
of whether they presented with the same or a different infection type, exhibited prolonged durations
of antibiotic de-escalation. This observation underscores the potential influence of the patient's
clinical trajectory and the necessity for adjunctive therapeutic interventions on the duration of
antibiotic de-escalation.
