Antibiotics prescription for targeted therapy of pediatric invasive pneumococcal diseases in China: a multicenter retrospective study.

BACKGROUND: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China. METHODS: A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed. RESULTS: 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid. CONCLUSIONS: Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use.

catena-Poly[[dinitratocopper(II)]-µ-4,4''-bis-(1H-benzimidazol-1-yl)-1,1':4',1''-terphen-yl].

In the title one-dimensional coordination polymer, [Cu(NO(3))(2)(C(32)H(22)N(4))](n), the Cu(2+) ion (site symmetry 2) is coordinated by two nitrate O atoms and two N atoms from two 4,4'-bis-(benzoimidazol-1-yl)terphenyl (L) ligands in a distorted cis-CuN(2)O(2) square-planar coordination geometry. An alternative description of the metal coordination geometry, if long Cu-O contacts to the bonded nitrate anions are considered, is an extremely distorted cis-CuN(2)O(4) octa-hedron. The complete L ligand is generated by crystallographic twofold symmetry and connects the metal ions into infinite chains propagating in [10[Formula: see text]]. The dihedral angle between the benzimidazole ring system and the adjacent benzene (B) ring is 51.12 (11)° and the dihedral angle between the B ring and the central ring is 19.45 (13)°.