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Seeking data partners - Antibiotics Overuse and Adverse Drug Events Associated with Sepsis in PICU

Hi everyone,

We are looking for collaborators/data partners to identify adverse drug events (ADEs) among pediatric patients with presumed sepsis and prescribed broad-spectrum antibiotics (BSAbx).

Sepsis is a life-threatening systemic infection and the leading cause of hospitalizations in the US [1, 2]. Annually, 1.7 million adults and 75,000 children are diagnosed with sepsis, and about 20% of these adults and 10% of these children die [3-6]. Survivors often suffer profound sequelae [7]. While expeditious BSAbx administration is the mainstay treatment for presumed sepsis, conversely, once started, this therapy is often unnecessarily prolonged [8, 9]. Extended exposure to BSAbx creates the public health threat of multi-drug-resistant bacterial infections and exposes patients to potential ADEs [10-12].

There are several aims for this project. The initial effort will be to develop the OMOP phenotypes for presumed pediatric sepsis. Then, we aim to identify the prevalence of various ADEs among pediatric patients with presumed sepsis and prescribed BSAbx. We will describe, on a high level, any associations between sepsis, BSAbx, observed ADEs, and other risk factors. From there, we aim to develop and validate an algorithm to predict the risk of ADEs to guide BSAbx administration in presumed pediatric sepsis.

We are looking for data partners to work on this study. If you have any suggestions or experience that would be suitable for this research question, we would love to hear from you!

Our team at Hopkins is led by Dr. Victoria Huang, Dr. James Fackler, Jen Wooyeon Park, and Star Liu.

Please reply here / DM me / contact me at [sliu197@jhmi.edu]

Thank you in advance for your help!

References

  1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315(8):801ā€“10.
  2. McDermott KW, Roemer M. Most Frequent Principal Diagnoses for Inpatient Stays in U.S. Hospitals, 2018 [Internet]. HCUP Statistical Brief #277. 2021 [cited 2021 Aug 31];Available from: https://hcup-us.ahrq.gov/reports/statbriefs/sb277-Top-Reasons-Hospital-Stays2018.jsp
  3. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). Sepsis: Clinical Information [Internet]. 2020 [cited 2021 Feb 7];Available from: Technical Resources & Guidelines | Sepsis | CDC
  4. Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis*. Pediatr Crit Care Med 2013;14(7):686ā€“93.
  5. Rhee C, Dantes R, Epstein L, et al. Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014. JAMA 2017;318(13):1241ā€“9.
  6. Sehgal M, Ladd HJ, Totapally B. Trends in Epidemiology and Microbiology of Severe Sepsis and Septic Shock in Children. Hospital Pediatrics 2020;10(12):1021ā€“30.
  7. Meert KL, Reeder R, Maddux AB, et al. Trajectories and Risk Factors for Altered Physical and Psychosocial Health-Related Quality of Life After Pediatric Community-Acquired Septic Shock. Pediatr Crit Care Med 2020;21(10):869ā€“78.
  8. Minderhoud TC, Spruyt C, Huisman S, Oskam E, Schuit SCE, Levin MD. Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis. Neth J Med 2017;75(5):196ā€“203.
  9. Battula V, Krupanandan RK, Nambi PS, Ramachandran B. Safety and Feasibility of Antibiotic De-escalation in Critically Ill Children With Sepsis - A Prospective Analytical Study From a Pediatric ICU. Front Pediatr 2021;9:640857.
  10. Centers for Disease Control and Prevention (U.S.). Antibiotic resistance threats in the United States, 2019 [Internet]. Centers for Disease Control and Prevention (U.S.); 2019 [cited 2021 Aug 15]. Available from: https://stacks.cdc.gov/view/cdc/82532 A comprehensive plan to optimize sepsis management Jim Fackler and Kimia Ghobadi 27 August 2023
  11. Arulkumaran N, Routledge M, Schlebusch S, Lipman J, Conway Morris A. Antimicrobialassociated harm in critical care: a narrative review. Intensive Care Med 2020;46(2):22535.
  12. Thorpe KE, Joski P, Johnston KJ. Antibiotic-Resistant Infection Treatment Costs Have Doubled Since 2002, Now Exceeding $2 Billion Annually. Health Affairs 2018;37(4):662ā€“9.
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Hello. Please count me in.
I can contribute with South Korea EMR(3M patients)

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Hello. We can contribute in executing the analysis and share the results in South Korea (Yonsei University Health System [YUHS], about 7M)

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Thank you so much, Jinchoi! We will keep you updated. In the meantime, if you have any tips/suggestions, please let me know.

Thank you so much as well, Seonji! We will keep you updated. In the meantime, if you have any tips/suggestions, please let me know.

This is an interesting project. Iā€™m interested in collaboration. Please let me know how I can be of any help.

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