Document Type
Article
Publication Date
8-15-2025
Identifier
DOI: 10.1017/ash.2025.10105; PMCID: PMC12394020
Abstract
OBJECTIVE: To describe the antimicrobial management of and examine the etiology of intracranial suppurative infections (ISIs) at a single pediatric institution.
DESIGN: Retrospective review.
PATIENTS: We included children hospitalized at a 367-bed freestanding pediatric institution for treatment of an ISI (epidural or subdural empyema, brain abscess) between January 1, 2015, and September 30, 2023. ISIs were identified using international classification of diseases 9/10 discharge diagnosis codes.
METHODS: We collected data regarding patient characteristics, infection etiology and complications, antimicrobial choice and route (empiric, definitive, and outpatient), microbiology results, treatment duration, and treatment-related outcomes from the electronic health record.
RESULTS: A total of 72 patients met inclusion criteria. Most patients received a third- or fourth-generation cephalosporin, metronidazole, and vancomycin empirically (69.4%), while a third- or fourth-generation cephalosporin in combination with metronidazole was the most common definitive regimen (63.9%). Almost half of patients (44%) were transitioned to an entirely oral antibiotic regimen, after a median of 27 days of intravenous therapy. The median duration of antimicrobial therapy was 45 days (interquartile range = 33,56). Organisms in the
CONCLUSIONS: Empiric therapy targeting resistant gram-positive organisms was not required to treat ISIs at our institution. Further data are needed on timing and requirements for oral antibiotic transition and treatment duration. In the future, there is opportunity for multi-institutional collaboration and data-sharing to determine the most appropriate management of pediatric ISIs.
Journal Title
Antimicrob Steward Healthc Epidemiol
Volume
5
Issue
1
First Page
186
Last Page
186
PubMed ID
40893130
Recommended Citation
Bizal CE, Burns AN, Feghaly REE, Lee BR, Wirtz AL. Evaluation of the antimicrobial management of intracranial suppurative infections in a single pediatric institution. Antimicrob Steward Healthc Epidemiol. 2025;5(1):e186. Published 2025 Aug 15. doi:10.1017/ash.2025.10105
Included in
Infectious Disease Commons, Pediatrics Commons, Pharmacy and Pharmaceutical Sciences Commons
Comments
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Publisher's Link: https://doi.org/10.1017/ash.2025.10105