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• W4384566559 abstract "<h3>Objectives</h3> The importance of early recognition and antimicrobial intervention in paediatric patients demonstrating clinical evidence of serious bacterial infection (SBI) is well-established with respect to morbidity and mortality outcomes.¹ Decreasing time to antibiotic (TTA) administration is associated with improved patient outcomes. Service protocols for paediatric patients focus upon early administration of intravenous (IV) antibiotics at presentation to an emergency department (ED). The aim of this project was to review factors influencing TTA administration among children presenting to the ED of a district general hospital with one or more age-appropriate observational parameters matching SIRS criteria or a clinical suspicion of SBI with a decision to commence IV antibiotics. <h3>Methods</h3> A retrospective search was performed to identify patients presenting within a ten-week period with a decision to commence IV antibiotics at presentation. The search was performed through retrospective review of patient records including admission and inpatient notes. These records were utilised to ascertain TTA administration in addition to identifying factors influencing the clinical area of administration. <h3>Results</h3> Fifty-seven patients were identified, with eighteen patients excluded due to insufficient data available or admission via alternative pathways. The mean TTA administration from point of decision to treat was 56 minutes (range 10–185 minutes). In those children receiving antibiotics in ED, the time to administration was significantly shorter compared to those whose treatment was deferred until arrival to the inpatient ward (39 vs. 80 minutes respectively). 52% of patients received IV antibiotic therapy for suspected SBI within a one-hour target. Notably this target was twice as likely to be achieved among children commencing IV antibiotics in the ED vs inpatient wards (85% vs. 33%). Factors found to influence the clinical area in which antibiotics were administered included nursing competencies, physicians awaiting laboratory results, uncertainty in clinician decision-making, difficult IV access, time to effect of topical anaesthetic and antibiotic availability. <h3>Conclusion</h3> Our data adds weight to the local debate about the protocolised delivery of antibiotics to children at high risk of SBI by suggesting an improved performance when administered in the ED setting. Many barriers to timely antibiotic administration in the ED were identified. Staff perceptions surrounding factors influencing these decisions vary significantly. This is worthy of further stakeholder discussion among ED and Paediatric teams as well as seeking factors influencing the patient experience. Future work will focus on establishing an agreed local pathway to reduce delays in antibiotic administration for these children. <h3>Reference</h3> Intensive Care Medicine. Weiss S L, Peters M J, Alhazzani W et al. (2020) Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. doi: 10.1007/s00134-019-05878-6. PMID: 32030529; PMCID: PMC7095013." @default.
• W4384566559 created "2023-07-18" @default.
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• W4384566559 date "2023-06-19" @default.
• W4384566559 modified "2023-10-16" @default.
• W4384566559 title "944 Paving the path for emergency antibiotic administration to children at high risk of serious bacterial infection" @default.
• W4384566559 doi "https://doi.org/10.1136/archdischild-2023-rcpch.688" @default.
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