Paediatric Common Infections Pathways: improving antimicrobial stewardship and promoting ambulation for children presenting with common infections to hospitals in the UK and Ireland

Carolyne Horner; Robert Cunney; Alicia Demirjian; Conor Doherty; Helen Green; Mathew Mathai; Paddy McMaster; Alasdair Munro; Stéphane Paulus; Damian Roland; Sanjay Patel

doi:10.1093/jacamr/dlab029

Paediatric Common Infections Pathways: improving antimicrobial stewardship and promoting ambulation for children presenting with common infections to hospitals in the UK and Ireland

JAC Antimicrob Resist. 2021 Mar 12;3(1):dlab029. doi: 10.1093/jacamr/dlab029. eCollection 2021 Mar.

Authors

Carolyne Horner¹, Robert Cunney², Alicia Demirjian³, Conor Doherty⁴, Helen Green⁵, Mathew Mathai⁶, Paddy McMaster⁷, Alasdair Munro⁵, Stéphane Paulus⁸, Damian Roland⁹, Sanjay Patel^{1

5}

Affiliations

¹ The British Society for Antimicrobial Chemotherapy, Birmingham, UK.
² Temple Street Children's University Hospital, Dublin, Ireland.
³ Evelina London Children's Hospital, London, UK.
⁴ Royal Hospital for Children, Glasgow, UK.
⁵ Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁶ Bradford Teaching Hospitals NHS Trust, Bradford, UK.
⁷ North Manchester General Hospital, Manchester, UK.
⁸ Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
⁹ University of Leicester NHS Trust, Leicester, UK.

Abstract

Paediatric common infection pathways have been developed in collaboration between the BSAC and national paediatric groups, addressing the management of cellulitis, lymphadenitis/lymph node abscess, pneumonia/pleural empyema, pyelonephritis, tonsillitis/peritonsillar abscess, otitis media/mastoiditis, pre-septal/post-septal (orbital) cellulitis, and meningitis. Guidance for the management of a child presenting with a petechial/purpuric rash and the infant under 3 months of age with fever is also provided. The aim of these pathways is to support the delivery of high-quality infection management in children presenting to a hospital. The pathways focus on diagnostic approaches, including the recognition of red flags suggesting complex or severe infection requiring urgent intervention, approaches to antimicrobial stewardship (AMS) principles and guidance on safe and timely ambulation aligned with good practice of outpatient parenteral antimicrobial therapy (OPAT).