Création et validation d'un outil d'aide à la décision pour optimiser l'usage des antimicrobiens aux soins intensifs pédiatriques


Patricia Fontela

Institut de recherche du Centre univesitarie de santé McGill


Domaine : santé de la mère, des enfants et des adolescents

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2014-2015

The majority of children admitted to a Pediatric Intensive Care Unit (PICU) receive antibiotics for suspected bacterial infections that were not definitively confirmed by laboratory tests. Because the recommendations about how long to use antibiotics in such situations are not clear, PICU physicians tend to unnecessarily prolong antibiotic treatment. This overuse of antibiotics presents harmful consequences that include drug-related toxicity and infections caused by antibiotic-resistant bacteria, such as Clostridium difficile.

To reduce antimicrobial overuse in PICUs, I propose a research program to develop a tool that will indicate to PICU physicians when it is safe to stop antibiotics in children with suspected bacterial infections. To do so, I will start by studying how PICU physicians make decisions about stopping antibiotics and what are the different clinical findings and laboratory tests that they use to help them to make these decisions. I will then evaluate these different clinical findings and laboratory tests to determine which ones can best predict infection cure. Finally, my research team and I will present our results to specialists in Infectious Diseases, Intensive Care, and Public Health, and together we will create the above mentioned tool.

The development of this tool is essential from a medical and public health viewpoint. It can realistically decrease antibiotic overuse in PICUs and consequently improve the health of seriously ill children in Québec and in the rest of Canada.