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Objective <p>To assess current international practices and perceptions regarding beta-lactam antibiotic administration in critically ill children with sepsis.</p> Design, setting, and participants <p>An electronic survey was distributed among physicians, advanced nurse practitioners and pharmacists working in paediatric intensive care units (PICUs) through PICU research networks from April to August 2024.</p> Main outcome measures <p>Demographic characteristics, current practices of beta-lactam (meropenem, piperacillin/tazobactam and cefotaxime) administration, reasons for infusion method choices, and perceptions on the efficacy of continuous and extended infusions.</p> Results <p>Two hundred sixty clinicians responded (236 physicians, 21 pharmacists, 2 advanced nurse practitioners) from 18 countries and 5 continents. Most respondents (88.1%) indicated use of beta-lactams as first-line antibiotics for children with sepsis, with intermittent infusion as the predominant standard practice across the selected beta-lactams (meropenem, 50.2%; piperacillin/tazobactam, 68.5%; and cefotaxime, 82.8%). Among respondents who opted for a continuous or extended infusion on an individual patient basis, 55.0% cited higher severity of illness as the primary reason for choosing this method for meropenem. The majority of respondents (86.5%) agreed there is lack of evidence to embed continuous and/or extended beta-lactam infusions into clinical practice and would recruit (84.6%) to a randomised controlled trial comparing continuous and/or extended and intermittent infusion.</p> Conclusions <p>This international survey highlights the lack of evidence in beta-lactam administration practices in treating critically ill children with sepsis. There is a clear need and desire for further research through randomised controlled trials to establish optimal beta-lactam infusion methods and investigate their impact on clinical outcomes in the paediatric patient population.</p>

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Beta-lactam antibiotic administration in critically ill children with sepsis: an international survey of current practice

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月10日

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  • Sainath Raman,
  • Rayna Reddy,
  • Daniela Carla de Souza,
  • Renee Cox,
  • Renate Le Marsney,
  • Karthi Nallasamy,
  • Padmanabhan Ramnarayan,
  • Jason A. Roberts,
  • Luregn J. Schlapbach,
  • Kristen S. Gibbons,
  • Tatjana Kerig,
  • Jennifer Darvas,
  • Marino Festa,
  • Shane George,
  • Corrine Balit,
  • Felix Oberender,
  • Simon Erickson,
  • Jenipher Chumbes Flores,
  • Karina Charles,
  • Michaela Waak,
  • Debbie Long,
  • Warwick Butt,
  • Carmel Delzoppo,
  • Ben Gelbart,
  • Kate Masterson,
  • Johnny Millar,
  • Anusha Ganeshalingam,
  • Claire Sherring,
  • Puneet Singh,
  • Vicky Smith

摘要

Objective

To assess current international practices and perceptions regarding beta-lactam antibiotic administration in critically ill children with sepsis.

Design, setting, and participants

An electronic survey was distributed among physicians, advanced nurse practitioners and pharmacists working in paediatric intensive care units (PICUs) through PICU research networks from April to August 2024.

Main outcome measures

Demographic characteristics, current practices of beta-lactam (meropenem, piperacillin/tazobactam and cefotaxime) administration, reasons for infusion method choices, and perceptions on the efficacy of continuous and extended infusions.

Results

Two hundred sixty clinicians responded (236 physicians, 21 pharmacists, 2 advanced nurse practitioners) from 18 countries and 5 continents. Most respondents (88.1%) indicated use of beta-lactams as first-line antibiotics for children with sepsis, with intermittent infusion as the predominant standard practice across the selected beta-lactams (meropenem, 50.2%; piperacillin/tazobactam, 68.5%; and cefotaxime, 82.8%). Among respondents who opted for a continuous or extended infusion on an individual patient basis, 55.0% cited higher severity of illness as the primary reason for choosing this method for meropenem. The majority of respondents (86.5%) agreed there is lack of evidence to embed continuous and/or extended beta-lactam infusions into clinical practice and would recruit (84.6%) to a randomised controlled trial comparing continuous and/or extended and intermittent infusion.

Conclusions

This international survey highlights the lack of evidence in beta-lactam administration practices in treating critically ill children with sepsis. There is a clear need and desire for further research through randomised controlled trials to establish optimal beta-lactam infusion methods and investigate their impact on clinical outcomes in the paediatric patient population.