A European Hospital Survey on Duration of Antibiotic Therapy for Common Paediatric Infections: What is Currently Recommended

METHODS: This survey was in the context of Antibiotic Resistance and Prescribing in European Children study (ARPEC). An electronic questionnaire was disseminated twice (September 2011 and November 2012) to ARPEC participants. We requested data on suggested treatment duration for commonly encountered infections: respiratory (RTI), skin and soft tissue (SSTI), bone and joint (OA), urinary tract and sepsis.

RESULTS: 82 paediatric hospitals from 19 European countries participated in the survey. 74/82 (90%) confirmed the existence of antibiotic guidelines for at least one infection group. 12/74 (16%) hospitals provided no data on treatment duration. Duration of therapy was most widely available for RTIs (80%) and less commonly available for SSTIs and OA infections (34% and 25% respectively). Median duration of therapy for AOM was 7 (5-10) days, for pneumonia 8 (7-10) days, UTI 10 (7-10) days, arthritis and osteomyelitis 21 (14-28) and 28 (21-28) days respectively. In terms of sepsis the median duration of therapy for culture negative sepsis in neonates was 7 (3-10) days, while for older infants and children 10 (10-14) days.

CONCLUSIONS: We documented lack of treatment duration guidance in European hospitals and great variation especially in treatment of neonatal sepsis. Stronger evidence in treatment duration for common paediatric infections is needed, a key component in any antibiotic stewardship program.