Objective: To understand current practice pattern in the management of pediatric IE in China.
Methods: This retrospective , multicenter study was conducted in 13 hospitals. Clinical data of 268 patients diagnosed as IE according to IE criteria between 2000 and 2006 were analysed. The mean age of patients was 8.94years(18d-18y).
Results:56 antibiotics were used to treat children with IE in our group. The most commonly used antibiotics in patients with streptococci detected were penicillin G , cephalosporin , vancomycin, penicillin & beta-lactamase inhibitor and aminoglycoside, in patients with staphylococci detected were cephalosporin , oxicillin, vancomycin, aminoglycoside, and quinolones. Only one antibiotic agent was used in 33(12.3%) , two in 83(31.1%) , 3 and more in 151(56.6%).Duration of antibiotic treatment was from 1 day to 98 days, <2 weeks in 19 (7%), 2weeks to <4 weeks in 74 (27.7%) , 4-6 weeks in 122(45.7%) , >6 weeks in 52 (19.4%). 123 patients simultaneously underwent surgical management. In antibiotics and surgical treatment group , 111(90.2%) were cured, 4 referred to surgery, 5(4%) died, 3 refused medical advice, in antibiotics alone treatment group, 75(51.7%) were cured, 13(8.96%) died, 57 refused medical advice. There was a significantly difference in outcomes between two groups ( p=0.000 ). The results of multivariable logistic regression analysis showed that staphylococci aureus as a pathogen, children with repaired congenital heart disease, and complicated with heart failure were risk factors related to death.
Conclusion: There were a wide range antibiotics and regimen used to manage children with IE in China