New Test Better Recognises Kids Who Need Oral or IV Antibiotics

Test to help clinicians choose between oral & intravenous (IV) antibiotics for childhood infections developed.

Researchers have devised a simple new test that will help clinicians decide whether to use oral or intravenous (IV) antibiotics to treat childhood infections.

According to a team from the Murdoch Children's Research Institute (MCRI) in Melbourne, Australia, clinicians often face a difficult choice in how best to treat childhood infections where antibiotics are needed.

According to lead author Laila Ibrahim, a doctoral student at MCRI,

Using IV antibiotics when they’re not needed means unnecessary hospitalisation, risk of complications and a financial burden on families and hospitals.

"Using oral antibiotics when IV is required risks children becoming more unwell, hence the need to standardise the decision between the two when treating childhood infections," she added.

Developed and validated in children attending the Royal Children's Hospital with a common skin infection, the Melbourne ASSET Risk Score is the first clinical risk score to help clinicians decide between IV and oral antibiotics in children.

The findings are published in the journal Pediatrics.

The Study

The team developed the risk score with 285 children aged six months to 18 years having cellulitis, a common skin infection for which the choice between oral and IV antibiotics is unclear.

Using a score out of seven, with four being the cut-off for IV use, the assessment examines the child's risk of sepsis, hand size, swelling, eyes and muscle tenderness.

While developed for cellulitis, the researchers said the risk score, which uses features that can be observed in the child and no extra invasive tests, could be adapted for other settings and different childhood infections.

The next step will be testing the assessment in children at other hospitals.