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Review
. 2022 Mar;36(1):203-218.
doi: 10.1016/j.idc.2021.11.003.

Diagnostic Stewardship in the Pediatric Intensive Care Unit

Anna C Sick-Samuels  1 , Charlotte Woods-Hill  2
Affiliations
Review

Diagnostic Stewardship in the Pediatric Intensive Care Unit

Anna C Sick-Samuels et al. Infect Dis Clin North Am. 2022 Mar.

Abstract

In the pediatric intensive care unit (PICU), clinicians encounter complex decision making, balancing the need to treat infections promptly against the potential harms of antibiotics. Diagnostic stewardship is an approach to optimize microbiology diagnostic test practices to reduce unnecessary antibiotic treatment. We review the evidence for diagnostic stewardship of blood, endotracheal, and urine cultures in the PICU. Clinicians should consider 3 questions applying diagnostic stewardship: (1) Does the patient have signs or symptoms of an infectious process? (2) What is the optimal diagnostic test available to evaluate for this infection? (3) How should the diagnostic specimen be collected to optimize results?

Keywords: Diagnostic stewardship; Pediatric intensive care; Sepsis; Urinary tract infection; Ventilator-associated infection.

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Conflict of interest statement

Disclosure The authors have no financial or commercial disclosures.

Figures

Figure 1.
Figure 1.
Diagnostic stewardship supplements antibiotic stewardship to optimize patient management of infectious processes.
Figure 2.
Figure 2.
Applying three steps of clinical diagnostic stewardship when assessing for bacterial infections commonly considered in the Pediatric Intensive Care Unit (PICU).
See this image and copyright information in PMC

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References

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