{
  "abstract": "Background Elastomeric devices (EDs) allow infusion of antibiotic via an intravenous catheter over 24 hours, supporting outpatient parenteral antimicrobial therapy. We conducted a systematic review of these devices in a paediatric population.Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used to review studies assessing antibiotic delivery through EDs in a paediatric population (0–21 years). Medline, Embase, CINAHL, PubMed, The Cochrane Clinical Trials Library, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched.Results After deduplication, 1789 titles and abstracts were screened; 45 underwent full-text review and nine were suitable for qualitative synthesis. 567 patients were treated in 657 episodes. 14 different antibiotics and aciclovir were delivered through EDs, primarily 24-hour infusions. Median treatment duration was 10 to 15 days. A variety of infections were treated (mostly infective exacerbations of cystic fibrosis (CF), bone/joint infection). Efficacy data were limited; two studies demonstrated non-inferiority of antibiotic therapy via ED for CF patients compared with conventional infusion pumps. In another study, only two patients (6%) experienced treatment failure. Few adverse events were reported: 1 of 34 patients (3%) experienced ED failure due to misplacement of the central line; one case of antibiotic crystallisation.Conclusion EDs have been used for a range of antimicrobial agents in children, in the treatment of a variety of infections, mostly in CF patients, and few adverse events were reported. Further studies should concentrate on new patient groups, and specific information about safety and cost effectiveness of ED in children is required.PROSPERO registration number CRD42021237146.",
  "authors": [
    {
      "affiliations": [
        "Paediatric Oncology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Lee Shipman"
    },
    {
      "affiliations": [
        "Medical School, University of Liverpool, Liverpool, UK"
      ],
      "name": "Vissagan Sankaranarayanan"
    },
    {
      "affiliations": [
        "Medical School, University of Liverpool, Liverpool, UK"
      ],
      "name": "Abhishek Agarwal"
    },
    {
      "affiliations": [
        "Medical School, University of Liverpool, Liverpool, UK"
      ],
      "name": "Jerry Chacko"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK"
      ],
      "name": "Amandine Charras"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK"
      ],
      "name": "Violet Swain"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK"
      ],
      "name": "Francesca Sposito"
    },
    {
      "affiliations": [
        "Pharmacy, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Octavio Aragon"
    },
    {
      "affiliations": [
        "Infectious Diseases, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "David Porter"
    },
    {
      "affiliations": [
        "Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, UK"
      ],
      "name": "Sanjay Valabh Patel"
    },
    {
      "affiliations": [
        "Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton, UK"
      ],
      "name": "Helen Green"
    },
    {
      "affiliations": [
        "NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK"
      ],
      "name": "Saul N Faust"
    },
    {
      "affiliations": [
        "Department of Paediatrics and Infectious Diseases, The Royal Children's Hospital, Melbourne, Victoria, Australia"
      ],
      "name": "Penelope A Bryant"
    },
    {
      "affiliations": [
        "Paediatric Oncology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Barry Pizer"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK",
        "National Institute for Health Research, Alder Hey Clinical Research Facility, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Daniel Hawcutt"
    }
  ],
  "title": "Evaluating antibiotic medications delivered through elastomeric devices in a paediatric population: a systematic review",
  "uid": "a7b9eb41-e757-5393-ba7b-7707eeff97f2"
}