Suspected respiratory tract infection in the tracheostomized child: the pediatric pulmonologist's approach

Chest
L S RusakowE H Mischler

Abstract

It is difficult to determine, in the child with a long-term tracheostomy, when bacterial airway colonization has progressed to a respiratory infection requiring antibiotic treatment. Our aim was to investigate whether there is a consensus regarding this and related chronic care issues among clinicians treating these patients. A questionnaire asking about practices regarding use of tracheal aspirate cultures and antibiotics was distributed to 47 pediatric pulmonary centers. Individuals representing 34 centers (72%), caring for 10 to 400 patients, responded. None. At 65% of centers, management is variable, dependent on the patient's underlying condition. The most common indications to obtain a culture were change in secretions (91%) or fever without an obvious source (21 centers). Indications to treat with antibiotics included many leukocytes in secretions (21 centers) or a respiratory illness (18 centers). When treating, 97% prescribe antibiotics empirically, most often enterally; nine centers use inhaled antibiotics. In most centers (79%), management is often done by telephone. Although pediatric pulmonologists tend to have similar approaches to assessment and management of suspected respiratory tract infections in tracheostomi...Continue Reading

Citations

Aug 30, 2006·Paediatric Respiratory Reviews·Ernst Eber, Béatrice Oberwaldner
Dec 27, 2005·International Journal of Hygiene and Environmental Health·Michel ToussaintPhilippe Soudon
Aug 28, 2004·The Annals of Otology, Rhinology, and Laryngology·Kenneth A GellerMaie A R St John
Jul 4, 2018·Pediatric Pulmonology·Catherine D SandersCharles R Esther
Feb 21, 2018·The Pediatric Infectious Disease Journal·Marcos Pérez-LosadaJonathan M Mansbach
May 24, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Bosco PaesIan Mitchell
Mar 14, 2021·International Journal of Pediatric Otorhinolaryngology·Emine AtagSedat Oktem

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