International Journal of Infectious Diseases (Sep 2022)
Use of broad-spectrum antibiotics in children diagnosed with multisystem inflammatory syndrome temporarily associated with SARS-CoV-2 infection in Poland: the MOIS-CoR study
- Kacper Toczyłowski,
- Joanna Łasecka-Zadrożna,
- Ilona Pałyga-Bysiecka,
- Kamila Maria Ludwikowska,
- Magdalena Okarska-Napierała,
- Natalia Dudek,
- Aneta Afelt,
- Catherine Suski,
- Miron Bartosz Kursa,
- Teresa Jackowska,
- Ernest Kuchar,
- Leszek Szenborn,
- Katarzyna Mazur-Melewska,
- Marta Barszcz,
- Elżbieta BerdejSzczot,
- Sebastian Brzuszkiewicz,
- Piotr Buda,
- Alicja Czajka,
- Agnieszka Czech,
- Ewa Czerwińska,
- Magdalena Figlerowicz,
- Małgorzata FirekPędras,
- Aneta Gawlik,
- Ewelina Gowin,
- Olga Izdebska,
- Danuta JanuszkiewiczLewandowska,
- Justyna Kiepuszka,
- Agnieszka Koczwara,
- Danuta Koszałko,
- Magdalena KośmiderŻurawska,
- Janusz Książyk,
- Beata Kucińska,
- Martyna Kukawska,
- Anita Lackowska,
- Katarzyna Łapacz,
- Agnieszka Maliszak,
- Anna Mania,
- Joanna Mańdziuk,
- Artur Mazur,
- Cezary Niszczota,
- Paulina OpalińskaZielonka,
- Katarzyna Rojewska,
- Anna RożnowskaWójtowicz,
- Bartosz Siewert,
- Paulina Sobiczewska,
- Lidia Stopyra,
- Agnieszka StrobaŻelek,
- Joanna StryczyńskaKazubska,
- Tomasz Szatkowski,
- Barbara Szczepańska,
- Maciej Szczukocki,
- Robert Szylo,
- Filip Tyc,
- Katarzyna Wielgos,
- Ewa Wołowska,
- Jacek Wysocki,
- Anna Zacharzewska,
- Marcin Zaniew,
- Marzena Zielińska,
- Katarzyna ZiębaGlonek
Affiliations
- Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Białystok, Waszyngtona 17, 15-274 Białystok, Poland
- Joanna Łasecka-Zadrożna
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
- Ilona Pałyga-Bysiecka
- Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland
- Kamila Maria Ludwikowska
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland
- Magdalena Okarska-Napierała
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
- Natalia Dudek
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
- Aneta Afelt
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland; Espace-DEV, IRD - Institut de Recherche pour le Développement, 500 rue Jean-François Breton - 34393 Montpellier Cedex 05, France
- Catherine Suski
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland
- Miron Bartosz Kursa
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, Pawinskiego 5A, 02-106, Warsaw, Poland
- Teresa Jackowska
- Department of Pediatrics, The Medical Centre of Postgraduate Education, Cegłowska 80, 01-809 Warsaw, Poland
- Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
- Leszek Szenborn
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland
- Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Szpitalna 27/33; 60-581 Poznań, Poland; Corresponding author: Katarzyna Mazur-Melewska. Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Szpitalna 27/33, 60-581 Poznań, Poland.
- Marta Barszcz
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland
- Elżbieta BerdejSzczot
- Department of Paediatrics and Paediatric Endocrinology, Upper-Silesian Paediatric Health Center School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
- Sebastian Brzuszkiewicz
- Provincial Specialist Children's Hospital Prof. S. Popowski in Olsztyn, ul. Żołnierska, 18a, 10-651 Olsztyn, Poland
- Piotr Buda
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
- Alicja Czajka
- Department of Pediatrics, Children's Hospital, ul. Niekłańska 4/24, 03-924, Warsaw, Poland
- Agnieszka Czech
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland
- Ewa Czerwińska
- Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368 Wroclaw, Poland
- Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Szpitalna 27/33; 60-581 Poznań, Poland
- Małgorzata FirekPędras
- Department of Paediatrics and Paediatric Endocrinology, Upper-Silesian Paediatric Health Center School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
- Aneta Gawlik
- Department of Paediatrics and Paediatric Endocrinology, Upper-Silesian Paediatric Health Center School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
- Ewelina Gowin
- Department of Preventive Health, Poznań University of Medical Science, Smoluchowskiego 11, 60-179, Poznan, Poland; Infectious Diseases Ward, Greater Poland Children's Health Centre; Wrzoska 1, 60-663, Poznań, Poland
- Olga Izdebska
- Clinical Department of Paediatrics and Nephrology, Voivodeship Complex Hospital L. Rydygiera in Toruń, ul. św. Józefa 53-59, 87-100, Toruń, Poland
- Danuta JanuszkiewiczLewandowska
- Department of Pediatric Oncology, Hematology and Transplantation, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572, Poznan, Poland
- Justyna Kiepuszka
- Specialist Hospital F. Ceynowy, ul. dr. A. Jagalskiego 10, 84-200, Wejherowo, Poland
- Agnieszka Koczwara
- Department of Pediatrics and Rheumatology, Specialist Hospital Antoniego Falkiewicza, Warszawska 2, 52-114, Wrocław, Poland
- Danuta Koszałko
- Independent Public Health Care, ul. Sukiennicza 13, 64-500, Szamotuły, Poland
- Magdalena KośmiderŻurawska
- Department of Anaesthesiology and Intensive Therapy, Wrocław Medical University, ul. Borowska 213, 50-556, Wrocław, Poland
- Janusz Książyk
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
- Beata Kucińska
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
- Martyna Kukawska
- Clinical Department of Pediatrics, Mazowiecki Specialist Hospital, ul. Aleksandrowicza 5, Radom, Poland
- Anita Lackowska
- Children's Hospital “Polanki”, Polanki 119, 80-308, Gdańsk, Poland
- Katarzyna Łapacz
- Department of Pediatrics, Children's Hospital, ul. Niekłańska 4/24, 03-924, Warsaw, Poland
- Agnieszka Maliszak
- Pediatric Ward, Regional Specialist Hospital, ul. Iwaszkiewicza 5, 59-220, Legnica, Poland
- Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Szpitalna 27/33; 60-581 Poznań, Poland
- Joanna Mańdziuk
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
- Artur Mazur
- Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland
- Cezary Niszczota
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
- Paulina OpalińskaZielonka
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, University of Rzeszów, Lwowska 60, 35-301, Rzeszów, Poland
- Katarzyna Rojewska
- Specialist Hospital F. Ceynowy, ul. dr. A. Jagalskiego 10, 84-200, Wejherowo, Poland
- Anna RożnowskaWójtowicz
- Department of Pediatrics, The Medical Centre of Postgraduate Education, Cegłowska 80, 01-809 Warsaw, Poland
- Bartosz Siewert
- Department of Preventive Health, Poznań University of Medical Science, Smoluchowskiego 11, 60-179, Poznan, Poland; Infectious Diseases Ward, Greater Poland Children's Health Centre; Wrzoska 1, 60-663, Poznań, Poland
- Paulina Sobiczewska
- Multidiscyplinary Hospital in Nowa Sól, ul. Chałubińskiego 1, 67-100, Nowa Sól, Poland
- Lidia Stopyra
- Department of Infectious Diseases and Paediatrics, S. Zeromski Hospital in Krakow, Osiedle Na Skarpie 66, 31-913, Kraków, Poland
- Agnieszka StrobaŻelek
- Chair and Department of Environmental Medicine and Epidemiology, Pediatric Ward, City Hospital in Ruda Śla?ska, Medical University of Silesia, ul. Wincentego Lipa 2, 41-703, Ruda Slaska, Poland
- Joanna StryczyńskaKazubska
- Department of Preventive Health, Poznań University of Medical Science, Smoluchowskiego 11, 60-179, Poznan, Poland; Infectious Diseases Ward, Greater Poland Children's Health Centre; Wrzoska 1, 60-663, Poznań, Poland
- Tomasz Szatkowski
- Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland
- Barbara Szczepańska
- Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland
- Maciej Szczukocki
- Collegium Medicum University of Jan Kochanowski, ul. Grunwaldzka 45, 25-736 Kielce, Poland
- Robert Szylo
- Chair and Department of Environmental Medicine and Epidemiology, Pediatric Ward, City Hospital in Ruda Śla?ska, Medical University of Silesia, ul. Wincentego Lipa 2, 41-703, Ruda Slaska, Poland
- Filip Tyc
- Congenital Heart Disease and Pediatric Cardiology Department, Silesian Center for Heart Diseases in Zabrze, ul. Marii Curie Skłodowskiej 9, 41-800, Zabrze, Poland
- Katarzyna Wielgos
- Department of Paediatrics, J. Gromkowski Regional Specialist Hospital in Wrocław, Koszarowa 5, Wrocław, Poland
- Ewa Wołowska
- Children's Hospital “Polanki”, Polanki 119, 80-308, Gdańsk, Poland
- Jacek Wysocki
- Department of Preventive Health, Poznań University of Medical Science, Smoluchowskiego 11, 60-179, Poznan, Poland; Infectious Diseases Ward, Greater Poland Children's Health Centre; Wrzoska 1, 60-663, Poznań, Poland
- Anna Zacharzewska
- University Clinical Center: Central Teaching Clinical Hospital, ul. Banacha 1A, 02-097, Warsaw, Poland
- Marcin Zaniew
- Department of Pediatrics, University of Zielona Góra, Zielona Gora, Poland
- Marzena Zielińska
- Department of Anaesthesiology and Intensive Therapy, Wrocław Medical University, ul. Borowska 213, 50-556, Wrocław, Poland
- Katarzyna ZiębaGlonek
- District Hospital of the name of Doctor T. Chalubinski in Zakopane, ul. Kamieniec 10, Zakopane
- Journal volume & issue
-
Vol. 122
pp. 703 – 709
Abstract
Objectives: Multisystem inflammatory syndrome in children (MIS-C) is the result of an immune response triggered by a previous exposure to SARS-CoV-2. The clinical presentation of MIS-C overlaps with other life-threatening bacterial infections, in which antimicrobials are the mainstay therapy. The aim of study was to describe the use of antibiotics in children with MIS-C in Poland. Methods: The analysis of 345 children reported from 42 Polish cities to the national MultiOrgan Inflammatory Syndromes COVID-19 Related Study (MOIS-CoR Study) from June 2020 to April 2021. Results: At least one antibiotic was used in 310 (90%) children, mainly third-generation cephalosporin (251/310). Broad-spectrum antibiotics were used in 258 (75%) children and 224 (87%) received this treatment for more than 3 days. Concentrations of serum procalcitonin >2 µg/l and the presence of lower respiratory symptoms were associated with increased odds of receiving any antibiotic. Conclusion: Although bacterial infections in patients with MIS-C are uncommon, we show that MIS-C poses a challenge to clinicians who are faced with the decision to start, continue, or stop antimicrobial therapy. Antibiotic stewardship in patients with MIS-C should be improved to ensure that likely pathogens are treated and that antimicrobials are stopped when bacterial infections are excluded and the diagnosis of MIS-C is made.
