[Clinical research of timing of application of antibiotics in septic shock of pediatric patients]

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013 Apr;25(4):207-10. doi: 10.3760/cma.j.issn.2095-4352.2013.04.007.
[Article in Chinese]

Abstract

Objective: To investigate the value of timing of antibiotics in pediatric septic shock.

Methods: Eighty children with septic shock treated with bundle treatment in Department of Critical Care Medicine were retrospectively analyzed. Eighty children with septic shock were divided into observation group (n=40, anti-infection therapy within 1 hour after admission) and control group (n=40, anti-infection therapy 1-6 hours after admission). The contents of lactate, C-reaction protein (CRP) and procalcitonin (PCT) were compared between two groups at admission and 24 hours and 72 hours after admission.

Results: Lactate in the observation group was significantly lower than that of the control group within the first 24 hours after admission (8.65 ± 2.84 mmol/L vs. 11.75 ± 3.20 mmol/L, P<0.01). CRP in the observation group was significantly lower than that of the control group 24 hours and 72 hours after admission (66.25 ± 8.55 mg/L vs. 91.77 ± 7.71 mg/L, 22.03 ± 7.46 mg/L vs. 50.11 ± 7.30 mg/L, both P<0.01). PCT in the observation group was significantly lower than that of the control group 72 hours after admission (0.67 ± 0.31 μg/L vs. 1.16 ± 0.25 μg/L, P<0.01). Time for shock recovery in the observation group was significantly shorter than that of the control group (6.80 ± 3.70 hours vs. 12.80 ± 3.63 hours, P<0.05), but no statistical difference in mortality rate between groups was found [5% (2/40) vs. 10% (4/40), P>0.05].

Conclusion: With the early empirical anti-infection treatment in pediatric septic shocked patients, time for recovery from shock can be shortened and successful rate of resuscitation can be improved.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use*
  • C-Reactive Protein / metabolism
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Child
  • Child, Preschool
  • Critical Care
  • Female
  • Humans
  • Infant
  • Lactic Acid / blood
  • Male
  • Prognosis
  • Protein Precursors / blood
  • Shock, Septic / drug therapy*
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • CALCA protein, human
  • Protein Precursors
  • Lactic Acid
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide