{"doi":"10.1093/cid/ciac698","title":"Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10-Center Point Prevalence Study","abstract":"BACKGROUND: Antibiotics are prescribed to most pediatric intensive care unit (PICU) patients, but data describing indications and appropriateness of antibiotic orders in this population are lacking. METHODS: We performed a multicenter point prevalence study that included children admitted to 10 geographically diverse PICUs over 4 study days in 2019. Antibiotic orders were reviewed for indication, and appropriateness was assessed using a standardized rubric. RESULTS: Of 1462 patients admitted to participating PICUs, 843 (58%) had at least 1 antibiotic order. A total of 1277 antibiotic orders were reviewed. Common indications were empiric therapy for suspected bacterial infections without sepsis or septic shock (260 orders, 21%), nonoperative prophylaxis (164 orders, 13%), empiric therapy for sepsis or septic shock (155 orders, 12%), community-acquired pneumonia (CAP; 118 orders, 9%), and post-operative prophylaxis (94 orders, 8%). Appropriateness was assessed for 985 orders for which an evidence-based rubric for appropriateness could be created. Of these, 331 (34%) were classified as inappropriate. Indications with the most orders classified as inappropriate were empiric therapy for suspected bacterial infection without sepsis or septic shock (78 orders, 24%), sepsis or septic shock (55 orders, 17%), CAP (51 orders, 15%), ventilator-associated infections (47 orders, 14%), and post-operative prophylaxis (44 orders, 14%). The proportion of antibiotics classified as inappropriate varied across institutions (range, 19%-43%). CONCLUSIONS: Most PICU patients receive antibiotics. Based on our study, we estimate that one-third of antibiotic orders are inappropriate. Improved antibiotic stewardship and research focused on strategies to optimize antibiotic use in critically ill children are needed.","journal":"Clinical Infectious Diseases","year":2022,"id":255678,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9152,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":778036,"name":"Jennifer Blumenthal","orcid":"0000-0002-9663-3747","position":1,"is_corresponding":false},{"id":516765,"name":"Juri Boguniewicz","orcid":"0000-0002-9248-780X","position":2,"is_corresponding":false},{"id":594353,"name":"Debra L. Palazzi","orcid":null,"position":3,"is_corresponding":false},{"id":903909,"name":"Erika Stalets","orcid":"0000-0002-6922-7372","position":4,"is_corresponding":false},{"id":668286,"name":"Jessica Rubens","orcid":"0000-0001-9198-9149","position":5,"is_corresponding":false},{"id":287739,"name":"Pranita D. Tamma","orcid":"0000-0002-4143-6324","position":6,"is_corresponding":false},{"id":904493,"name":"Stephanie S. Cabler","orcid":null,"position":7,"is_corresponding":false},{"id":435559,"name":"Jason G. Newland","orcid":"0000-0001-9979-7993","position":8,"is_corresponding":false},{"id":859322,"name":"Hillary Crandall","orcid":"0000-0002-5392-8457","position":9,"is_corresponding":false},{"id":903910,"name":"Emily Berkman","orcid":"0000-0001-8823-487X","position":10,"is_corresponding":false},{"id":903911,"name":"Robert Kavanagh","orcid":"0000-0001-8214-0274","position":11,"is_corresponding":false},{"id":904494,"name":"Hannah Stinson","orcid":null,"position":12,"is_corresponding":false},{"id":91692,"name":"Jeffrey S. Gerber","orcid":"0000-0002-3076-3186","position":13,"is_corresponding":false},{"id":246182,"name":"Kathleen Chiotos","orcid":"0000-0002-0204-8708","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T00:25:17.224217Z","pmid":"36048543","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}