Universidad Peruana Cayetano Heredia

The use of antibiotics in the treatment of pediatric varicella patients: real-world evidence from the multi-country MARVEL study in Latin America & Europe.

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dc.contributor.author Wolfson, Lara J.
dc.contributor.author Castillo, Maria Esther
dc.contributor.author Giglio, Norberto
dc.contributor.author Meszner, Zsofia
dc.contributor.author Molnar, Zsuzsanna
dc.contributor.author Vazquez, Mirella
dc.contributor.author Wysocki, Jacek
dc.contributor.author Altland, Alexandra
dc.contributor.author Kuter, Barbara J.
dc.contributor.author Stutz, Melissa
dc.contributor.author Rampakakis, Emmanouil
dc.contributor.author Roberts, Craig S.
dc.date.accessioned 2019-08-08T15:23:44Z
dc.date.available 2019-08-08T15:23:44Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7129
dc.description.abstract BACKGROUND: Varicella is a highly contagious childhood disease. Generally benign, serious complications necessitating antibiotic use may occur. The objective of this study was to characterize the rate, appropriateness and patterns of real-world antibiotic prescribing for management of varicella-associated complications, prior to universal varicella vaccination (UVV) implementation. METHODS: Pooled, post-hoc analysis of 5 international, multicenter, retrospective chart reviews studies (Argentina, Hungary, Mexico, Peru, Poland). Inpatient and outpatient primary pediatric (1-14 years) varicella cases, diagnosed between 2009 and 2016, were eligible. Outcomes, assessed descriptively, included varicella-associated complications and antibiotic use. Three antibiotic prescribing scenarios were defined based on complication profile in chart: evidence of microbiologically confirmed bacterial infection (Scenario A); insufficient evidence confirming microbiological confirmation (Scenario B); no evidence of microbiological confirmation (Scenario C). Stratification was performed by patient status (inpatient vs. outpatient) and country. RESULTS: Four hundred one outpatients and 386 inpatients were included. Mean (SD) outpatient age was 3.6 (2.8) years; inpatient age was 3.1 (2.8) years. Male gender was predominant. Overall, 12.2% outpatients reported >/=1 infectious complication, 3.7% >/=1 bacterial infection, and 0.5% >/=1 microbiologically confirmed infection; inpatient complication rates were 78.8, 33.2 and 16.6%, respectively. Antibiotics were prescribed to 12.7% of outpatients and 68.9% of inpatients. Among users, beta-lactamases (class), and clindamycin (agent), dominated prescriptions. Scenario A was assigned to 3.9% (outpatients) vs 13.2% (inpatients); Scenario B: 2.0% vs. 6.0%; Scenario C: 94.1% vs. 80.8%. CONCLUSIONS: High rates of infectious complications and antibiotic use are reported, with low rates of microbiological confirmation suggesting possible antibiotic misuse for management of varicella complications. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Public Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adolescent en_US
dc.subject Adolescent en_US
dc.subject Anti-Bacterial Agents en_US
dc.subject Anti-Bacterial Agents/therapeutic use en_US
dc.subject antiinfective agent en_US
dc.subject Antimicrobial stewardship en_US
dc.subject bacterial infection en_US
dc.subject Bacterial Infections en_US
dc.subject Bacterial Infections/drug therapy/microbiology en_US
dc.subject beta lactamase en_US
dc.subject beta-Lactamases en_US
dc.subject beta-Lactamases/therapeutic use en_US
dc.subject chickenpox en_US
dc.subject Chickenpox en_US
dc.subject Chickenpox/drug therapy/epidemiology/virology en_US
dc.subject child en_US
dc.subject Child en_US
dc.subject Child, Preschool en_US
dc.subject clindamycin en_US
dc.subject Clindamycin en_US
dc.subject Clindamycin/therapeutic use en_US
dc.subject Delivery of Health Care en_US
dc.subject Delivery of Health Care/standards en_US
dc.subject Drug Prescriptions en_US
dc.subject Drug Prescriptions/statistics & numerical data en_US
dc.subject Europe en_US
dc.subject Europe/epidemiology en_US
dc.subject female en_US
dc.subject Female en_US
dc.subject health care delivery en_US
dc.subject hospital patient en_US
dc.subject hospitalization en_US
dc.subject Hospitalization en_US
dc.subject human en_US
dc.subject Humans en_US
dc.subject infant en_US
dc.subject Infant en_US
dc.subject Inpatients en_US
dc.subject Latin America en_US
dc.subject Latin America/epidemiology en_US
dc.subject male en_US
dc.subject Male en_US
dc.subject microbiology en_US
dc.subject Observation study en_US
dc.subject outpatient en_US
dc.subject Outpatients en_US
dc.subject Pediatrics en_US
dc.subject preschool child en_US
dc.subject prescription en_US
dc.subject Retrospective Studies en_US
dc.subject retrospective study en_US
dc.subject South and Central America en_US
dc.subject standards en_US
dc.subject statistics and numerical data en_US
dc.subject Varicella en_US
dc.subject virology en_US
dc.title The use of antibiotics in the treatment of pediatric varicella patients: real-world evidence from the multi-country MARVEL study in Latin America & Europe. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12889-019-7071-z
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1471-2458


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