Article in Japanese

Pediatric infectious disease consultation service by adult infectious disease specialists in a Japanese community-care hospital

Akihiko SHIMIZU¹⁾, Toru HIGUCHI²⁾, Hiroaki ITO²⁾, Takahiro UEHARA²⁾

Consultation on pediatric infectious disease (ID) is not available for most pediatricians in Japanese community-care hospitals because the number of pediatric ID specialists is limited in the country. The aim of this study was to evaluate the demand for pediatric ID consultation in this hospital, where every doctor can consult with adult ID specialists. This study conducted a retrospective cohort research on pediatric ID consultations in Kameda Medical Center. All cases between January 2006 and August 2015 were identified from the database of this study. Patient demographic, clinical data and the reason for ID consultation were evaluated. Among 106 consultations, 82 were from the pediatric ward, 14 from the neonatal intensive care unit, and 10 from the outpatient department. The median patient age was 3 years (IQR 0-6 years). Seventeen consultations requested permission to use carbapenems, primarily for severe infections or resistant pathogens. Reasons for other consultations included choice of antibiotics (n=33), duration of antimicrobial therapy (n=20), fever workup (n=11, infection control measures (n=9), vaccinations (n=4), patients with suspected sexually transmitted disease (n=4), those with suspected tuberculosis (n=3), those with suspected imported ID (n=2), and other IDs (n=3). Pediatric ID consultations are requested for infections that are severe, caused by resistant organisms, and infrequent in children. Adult ID specialists can aid in the management of pediatric ID in community-care hospitals.

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1) Department of Infectious Diseases, 2) Department of Pediatrics, Kameda Medical Center

Key words	infectious disease consultation, infectious diseases specialist, proper use of antibiotics, antimicrobial stewardship program(ASP)
Received	August 2, 2017
Accepted	November 2, 2017

29 (4)：322─330,2018