Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children

systematic review and guidelines

Brendan J. McMullan, David Andresen, Christopher C. Blyth, Minyon L. Avent, Asha C. Bowen, Philip N. Britton, Julia E. Clark, Celia M. Cooper, Nigel Curtis, Emma Goeman, Briony Hazelton, Gabrielle M. Haeusler, Ameneh Khatami, James P. Newcombe, Joshua Osowicki, Pamela Palasanthiran, Mike Starr, Tony Lai, Clare Nourse, Joshua R. Francis & 2 others David Isaacs, Penelope A. Bryant

    Research output: Contribution to journalReview articleResearchpeer-review

    Abstract

    Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identified and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.

    Original languageEnglish
    Pages (from-to)e139-e152
    Number of pages14
    JournalLancet Infectious Diseases
    Volume16
    Issue number8
    DOIs
    Publication statusPublished - 1 Aug 2016

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    Bacterial Infections
    Guidelines
    Anti-Bacterial Agents
    Infection
    Communicable Diseases
    Meta-Analysis
    Randomized Controlled Trials
    Biomarkers
    Databases
    Pediatrics
    Research

    Cite this

    McMullan, Brendan J. ; Andresen, David ; Blyth, Christopher C. ; Avent, Minyon L. ; Bowen, Asha C. ; Britton, Philip N. ; Clark, Julia E. ; Cooper, Celia M. ; Curtis, Nigel ; Goeman, Emma ; Hazelton, Briony ; Haeusler, Gabrielle M. ; Khatami, Ameneh ; Newcombe, James P. ; Osowicki, Joshua ; Palasanthiran, Pamela ; Starr, Mike ; Lai, Tony ; Nourse, Clare ; Francis, Joshua R. ; Isaacs, David ; Bryant, Penelope A. / Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children : systematic review and guidelines. In: Lancet Infectious Diseases. 2016 ; Vol. 16, No. 8. pp. e139-e152.
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    title = "Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines",
    abstract = "Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identified and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.",
    author = "McMullan, {Brendan J.} and David Andresen and Blyth, {Christopher C.} and Avent, {Minyon L.} and Bowen, {Asha C.} and Britton, {Philip N.} and Clark, {Julia E.} and Cooper, {Celia M.} and Nigel Curtis and Emma Goeman and Briony Hazelton and Haeusler, {Gabrielle M.} and Ameneh Khatami and Newcombe, {James P.} and Joshua Osowicki and Pamela Palasanthiran and Mike Starr and Tony Lai and Clare Nourse and Francis, {Joshua R.} and David Isaacs and Bryant, {Penelope A.}",
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    language = "English",
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    McMullan, BJ, Andresen, D, Blyth, CC, Avent, ML, Bowen, AC, Britton, PN, Clark, JE, Cooper, CM, Curtis, N, Goeman, E, Hazelton, B, Haeusler, GM, Khatami, A, Newcombe, JP, Osowicki, J, Palasanthiran, P, Starr, M, Lai, T, Nourse, C, Francis, JR, Isaacs, D & Bryant, PA 2016, 'Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines', Lancet Infectious Diseases, vol. 16, no. 8, pp. e139-e152. https://doi.org/10.1016/S1473-3099(16)30024-X

    Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children : systematic review and guidelines. / McMullan, Brendan J.; Andresen, David; Blyth, Christopher C.; Avent, Minyon L.; Bowen, Asha C.; Britton, Philip N.; Clark, Julia E.; Cooper, Celia M.; Curtis, Nigel; Goeman, Emma; Hazelton, Briony; Haeusler, Gabrielle M.; Khatami, Ameneh; Newcombe, James P.; Osowicki, Joshua; Palasanthiran, Pamela; Starr, Mike; Lai, Tony; Nourse, Clare; Francis, Joshua R.; Isaacs, David; Bryant, Penelope A.

    In: Lancet Infectious Diseases, Vol. 16, No. 8, 01.08.2016, p. e139-e152.

    Research output: Contribution to journalReview articleResearchpeer-review

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    AU - Andresen, David

    AU - Blyth, Christopher C.

    AU - Avent, Minyon L.

    AU - Bowen, Asha C.

    AU - Britton, Philip N.

    AU - Clark, Julia E.

    AU - Cooper, Celia M.

    AU - Curtis, Nigel

    AU - Goeman, Emma

    AU - Hazelton, Briony

    AU - Haeusler, Gabrielle M.

    AU - Khatami, Ameneh

    AU - Newcombe, James P.

    AU - Osowicki, Joshua

    AU - Palasanthiran, Pamela

    AU - Starr, Mike

    AU - Lai, Tony

    AU - Nourse, Clare

    AU - Francis, Joshua R.

    AU - Isaacs, David

    AU - Bryant, Penelope A.

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    N2 - Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identified and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.

    AB - Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identified and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.

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