Article in Japanese

Pseudomonas aeruginosa in children with tracheostomy: colonization or infection?

Yu-Hao CHEN¹⁾, Takayo SHOJI^1,2)

Colonization of the lower respiratory tract by Pseudomonas aeruginosa frequently occurs in tracheostomized patients. While the pathogenicity of P. aeruginosa is not clear in patients with lower respiratory tract infection, anti-pseudomonal antibiotics have been used widely as empirical treatment in some circumstances due to lack of appropriate clinical practice guidelines. This study retrospectively reviewed tracheostomized pediatric patients who were admitted to the General Pediatric Ward in Shizuoka Children's Hospital, and had their clinical courses compared between those treated with and without anti-pseudomonal antibiotics. Twenty nine children were enrolled with 135 episodes on hospital admission. P. aeruginosa grew from aspirated sputum culture in 19 cases, with 62 episodes. The duration of fever and requirement of additional oxygen supply were no different between the two groups, with no difference in respiratory failure or deteriorating infection between them. Conclusion: Anti-pseudomonal antibiotics as empirical antibiotic may be inappropriate treatment for moderate lower respiratory tract infection in tracheostomized children without immunocompromising condition.

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1) Department of General Pediatrics, Shizuoka Children's Hospital
2) Department of Pediatric Infectious Disease, Shizuoka Children's Hospital

Key words	antibiotic stewardship program(ASP), Pseudomonas aeruginosa
Received	December 21, 2017
Accepted	May 12, 2018

30 (3)：187─195,2018