Use of inhaled antibiotics as a preventive measure for respiratory tract infections in pediatric patients with a tracheostomy: A retrospective descriptive study.
CCCF ePoster library. Jutras C. Oct 2, 2017; 198143
Camille Jutras
Camille Jutras
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Use of inhaled antibiotics as a preventive measure for respiratory tract infections in pediatric patients with a tracheostomy: A retrospective descriptive study.

Jutras, Camille1; Autmizguine, Julie2; Chomton, Maryline1; Marquis, Christopher1; Nguyen, The Thanh Diem3; Emeriaud, Guillaume 1.

 

1Pediatric intensive care department, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.

2 Infectious diseases department, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.

3 Pediatric pneumology department, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.

 

 


Introduction: Ventilator-associated respiratory tract infections are a cause of morbidity and mortality in children with a tracheostomy. In addition, they cause greater exposition to broad-spectrum antibiotics. The use of inhaled antibiotics as a preventive measure to reduce ventilator-associated infections has not been studied in children with a tracheostomy.
 
Objectives: To determine if the use of preventive inhaled antibiotics in this population reduces the risk of acquired respiratory tract infections and reduces exposition to broad-spectrum antibiotics.
 
Methods: A retrospective study was performed by reviewing charts of all patients aged between 0 to 18 years old with a tracheostomy, hospitalised at the CHU Sainte Justine between January 2004 and November 2016 and treated with inhaled antibiotics as a preventive measure. The primary outcome was exposition to broad-spectrum antibiotics in the 3-month period before and after the beginning of the preventive treatment with inhaled antibiotics. Adverse effects were also evaluated.
 
Results: Six patients (median age: 10.0 months, interquartile: 8.3-11.0) were included in our analysis. One of them received colimycin, 3 received tobramycin and 2 were treated with both alternately. The median time of treatment was 74 days (69-161). Patients were exposed to broad spectrum antibiotics during 18 days (5-31) in the 3 months preceding the treatment versus 2 days (0-3) in the 3 months following the treatment initiation, p= 0,115 (Wilcoxon). The number of respiratory tract infections went from 2 (1-3) to 1 (0-1) during the same periods, p=0,066. Adverse effects most commonly reported were cough (n=2) and increased respiratory secretions post-inhalation (n=4). No new colonisation with antibiotics-resistant bacteria was observed in the 12 following months.
 
Conclusion: Although limited by the small sample size, these results support the design of future studies to evaluate the potential clinical impact of preventive inhaled antibiotics in children with a tracheostomy.

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