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Use of broad-spectrum antibiotics in children diagnosed with multisystem inflammatory syndrome temporarily associated with SARS-CoV-2 infection in Poland: the MOIS-CoR study

2022; Elsevier BV; Volume: 122; Linguagem: Inglês

10.1016/j.ijid.2022.07.021

1878-3511

Kacper Toczyłowski, Joanna Łasecka-Zadrożna, Ilona Pałyga-Bysiecka, Kamila Ludwikowska, Magdalena Okarska‐Napierała, Natalia Dudek, Aneta Afelt, Catherine Suski, Miron B. Kursa, Teresa Jackowska, Ernest Kuchar, Leszek Szenborn, Marta Sawicka, Elżbieta Berdej-Szczot, Sebastian Brzuszkiewicz, Piotr Buda, Alicja Czajka, Agnieszka Czech, Ewa Czerwińska, Magdalena Figlerowicz, Małgorzata Firek-Pędras, Aneta Gawlik, Ewelina Gowin, Olga Izdebska, Danuta Januszkiewicz‐Lewandowska, Justyna Kiepuszka, A Koczwara, Danuta Koszałko, Magdalena Kośmider‐Żurawska, Janusz Książyk, Beata Kucińska, Martyna Kukawska, Anita Lackowska, Katarzyna Łapacz, Agnieszka Maliszak, Anna Mania, Joanna Mańdziuk, Artur Mazur, Cezary Niszczota, Paulina Opalińska-Zielonka, Katarzyna Rojewska, Anna Rożnowska-Wójtowicz, Bartosz Siewert, Paulina Sobiczewska, Lidia Stopyra, Agnieszka Stroba-Żelek, Joanna Stryczyńska-Kazubska, Artur Sulik, Tomasz Szatkowski, Barbara Szczepańska, Maciej Szczukocki, Robert Szylo, Filip Tyc, Katarzyna Wielgos, Ewa Wołowska, Jacek Wysocki, Anna Zacharzewska, Marcin Zaniew, Marzena Zielińska, Katarzyna Zięba-Glonek, Katarzyna Mazur‐Melewska,

Pneumonia and Respiratory Infections

Multisystem inflammatory syndrome in children (MIS-C) is the result of an immune response triggered by a previous exposure to SARS-CoV-2. The clinical presentation of MIS-C overlaps with other life-threatening bacterial infections, in which antimicrobials are the mainstay therapy. The aim of study was to describe the use of antibiotics in children with MIS-C in Poland.The analysis of 345 children reported from 42 Polish cities to the national MultiOrgan Inflammatory Syndromes COVID-19 Related Study (MOIS-CoR Study) from June 2020 to April 2021.At least one antibiotic was used in 310 (90%) children, mainly third-generation cephalosporin (251/310). Broad-spectrum antibiotics were used in 258 (75%) children and 224 (87%) received this treatment for more than 3 days. Concentrations of serum procalcitonin >2 µg/l and the presence of lower respiratory symptoms were associated with increased odds of receiving any antibiotic.Although bacterial infections in patients with MIS-C are uncommon, we show that MIS-C poses a challenge to clinicians who are faced with the decision to start, continue, or stop antimicrobial therapy. Antibiotic stewardship in patients with MIS-C should be improved to ensure that likely pathogens are treated and that antimicrobials are stopped when bacterial infections are excluded and the diagnosis of MIS-C is made.