No Prophylactic Antibiotic Use for Young Children\u2019s Intussusception with Low-risk Infection after Successful Air Enema Reduction

Yuan Zhang,Qian Liu,Yinghui Zhang,Lemeng Ren,Huandi Liu,Hongying Jia,Chunfeng Si,Zhaohui Sun,Wen Zou

doi:10.1038/s41598-018-24415-x

Abstract

The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.

Highlights

The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011
No significant differences were observed between two groups in age, gender, weight, admission period, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications (P > 0.05)
Routine antibiotic administration before enema reduction is often advocated for intussusception

Summary

Introduction

The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. A retrospective nonrandomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. We conducted this study to explore whether the prophylactic application of antibiotics had clinical significance for patients with low-risk intussusception

Methods

Results

Conclusion