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Respiratory Viral Infections Research / Pneumonia and Respiratory Infections · Journal article
Pathogens · August 12, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-centre retrospective analysis describes antibiotic prescribing patterns in hospitalized children from 2021 to 2024, showing a shift toward viral diagnoses, rising cephalosporin use (especially ceftriaxone), and frequent off-target prescribing (antibiotics given for viral infections). The work identifies stewardship opportunities but provides no evidence of effectiveness, safety, or whether prescribing changes improved outcomes.
Retrospective descriptive cohort study. Children admitted to the pediatric ward with a positive microbiological finding (bacterial or viral isolate) at a tertiary hospital in Split, Croatia.. n = 567. Tertiary hospital pediatric ward in Split, Croatia.
Proportion of children receiving antibiotics rose from 60.5% (26/43) in 2021 to 71.4% (130/182) in 2024 DOT peaked in 2022 at 2164/1000 PD before settling near 1400/1000 PD Ceftriaxone usage rose fivefold from 150 to 755 DOT/1000 PD to become the leading agent
No clinical outcome data (mortality, length of stay, readmission, resistance rates) reported; no assessment of prescribing appropriateness or guideline adherence.
This descriptive report identifies antibiotic stewardship gaps—particularly high off-target prescribing of antibiotics for viral infections and rising cephalosporin use—that warrant intervention. However, it does not demonstrate whether prescribing patterns affected clinical outcomes, safety, or antimicrobial resistance, and results are from a single centre.
Single-centre retrospective analysis of antimicrobial prescribing patterns without intervention, comparator group, or clinical outcome; descriptive surveillance data that identifies trends and stewardship opportunities but does not test efficacy or safety.
As stated by the source record.
Quoted from the source exactly as published.
This descriptive report identifies antibiotic stewardship gaps—particularly high off-target prescribing of antibiotics for viral infections and rising cephalosporin use—that warrant intervention. However, it does not demonstrate whether prescribing patterns affected clinical outcomes, safety, or antimicrobial resistance, and results are from a single centre.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
The COVID-19 pandemic shifted pediatric infection epidemiology from bacterial toward viral predominance as public health measures relaxed. To determine how hospital antibiotic prescribing adapted, antimicrobial consumption was characterized and linked to underlying pathogen type. Antibiotic use was retrospectively analyzed among 567 children admitted with a positive microbiological finding to the pediatric ward of a tertiary hospital in Split, Croatia, during the first quarters of 2021–2024. Consumption was quantified using Days of Therapy (DOT), Length of Therapy (LOT), and Days of Antibiotic Spectrum Coverage (DASC) per 1000 patient-days (PD). Antibiotics were grouped by the WHO Access/Watch/Reserve (AWaRe) classification and linked to discharge diagnosis and pathogen type. The proportion of children receiving antibiotics rose from 60.5% (26/43) in 2021 to 71.4% (130/182) in 2024, with the cohort shifting toward younger infants and virally driven diagnoses. DOT, DASC, and DOT/LOT peaked in 2022 (DOT 2164/1000 PD, DOT/LOT 2.2) before settling near 1400/1000 PD, with mean per-day spectrum (DASC/DOT) declining modestly (7.7 to 6.8). Watch-group antibiotics dominated throughout (~80%), with Access contribution of ~20% and Reserve antibiotic use negligible. Ceftriaxone usage rose fivefold (150 to 755 DOT/1000 PD) to become the leading agent. Ceftriaxone and azithromycin were administered more often to children with viral than bacterial infections (respiratory syncytial virus being most common), whereas vancomycin and meropenem were tied to bacterial isolates. These findings identify a high-yield stewardship target and underscore the value of multi-metric, pathogen-aware surveillance.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.