Joining Patrick Bafuma again is Dr. John Perkins from Carilion Clinic in Virginia this time to discuss antibiotic stewardship in pediatric patients.
Antibiotics are not without significant risk especially in pediatric patients. Approximately half of all adverse drug events (ADEs) are related to antibiotics. A recent piece of literature demonstrated that over 40% of antibiotic ADEs were with children under two years of age. Overall, about 3% of these patients will be hospitalized. This indicates that antibiotics are not without risk and we need to decide when to use them appropriately.
It is important to have buy-in throughout the system. One person saying not to give any antibiotics and another person to give them much more freely can be confusing to other clinicians as well as to the patients and their family. It is important to discuss options for management such as watchful waiting (think otitis media), clear shared decision making (check these pearls), and important word choice. This last one is important to explain that antibiotics are not without risk especially with illnesses that are likely to be viral and the antibiotics are unlikely to benefit.
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