1

Problem-Based Research: Pediatric Antibiotics

DeJana Rodriguez

Delaware Technical Community College

NUR 340: Nursing Research 

Dr. K. Heacock

April 23, 2023

 2

Problem-Based Research: Pediatric Antibiotics

This research paper will review the effects antibiotics have on the pediatric population.

Antibiotics are used to treat infections but are often prescribed unnecessarily. While antibiotics

are extremely effective, when necessary, the misuse of them can cause more harm than danger.

Protecting the pediatric population through best practices is extremely important. That makes

this topic a relevant issue requiring further research.

Statement of the Problem

As previously mentioned, antibiotics are often prescribed to children unnecessarily.

Prescribing antibiotics unnecessarily leads to antibiotic resistance bacteria that can subject

children to more harmful issues. It can also negatively affect a child’s natural immunity, making

them more vulnerable to harsh microbes. Understanding why antibiotics are often misused

provides the baseline of which gives a starting point for fixing the issue. Further delving into the

effects of antibiotics on children provides an understanding of why it is important to prescribe

only when necessary. This leads to my research question of “How do antibiotics affect a child’s

immunity?”

The impact of the over prescribing of antibiotics is significant to nursing practice as it

provides an avenue for the nurse to advocate. Antibiotic stewardship is extremely important in

this matter and nurses play a vital role in it. Having the proper information allows nurses to

advocate for the youth and possibly find an alternate solution. Implementing best practice based

on research will allow for better care of the pediatric population. It will also prevent future harm

by minimizing the creation of super bugs.

Literature Review
 3

Antibiotic resistant microbes cause about 35,000 deaths and about 3 million infections

annually in the US (Gerber et al., 2020). In the article Antibiotic Stewardship in Pediatrics the

importance of proper use of antibiotics in children is explained. Identifying the need for

stewardship in relation to prescribing antibiotics for children was key in identifying this topic as

an issue. Explaining the overuse of antibiotics as a public health threat provided the need for

intervention. This article presents evidence for the need of antibiotic stewardship programs

(ASPs) in both inpatient and outpatient settings. It relates to my research question as it provides

detail regarding the negative effects of the improper use of antibiotics and provides solutions to

discontinue unnecessary use.

Most children are prescribed antibiotics in the first two years of their life while vaccine

immunity is still developing (Chapman et al., 2022). In the article Antibiotic Use and Vaccine

Antibody Levels research is conducted to provide information on the effects of antibiotic use in

children while their immunity is building from vaccinations. Antibody measurements were made

in relation to inactivated polio (IPV), Haemophilus influenzae type b (Hib), diphtheria-tetanus-

acellular pertussis (DTaP), and pneumococcal conjugate (PCV) vaccines in children who were

given antibiotics and not. The conclusion drawn from this study was children 2yrs of age and

younger vaccination antibodies were lowered when prescribed antibiotics. This research is

significant to my research question as it gives an example of how antibiotics affect a child’s

active immunity.

The Dark Side of Antibiotics: Adverse Effects on the Infant Immune Defense Against

Infection article discusses how antibiotics negatively affect an infant child. Frequent use of

antibiotics in infants increases their susceptibility to widespread infections and diseases that can

negatively affect them later in life (Shekhar & Petersen, 2020). It also alters their immune
 4

response making an already vulnerable population more vulnerable. Due to antibiotics often

being prophylactically used when an infant has an infection the use of antibiotics is often

inevitable in this population. This article uses qualitative research to provide facts regarding the

negative effects on the infants’ immune system from the overuse of antibiotics. It specifically

addresses my research question by providing direct effects. The article uses research completed

in mice for comparison and ultimately draws the conclusion that antibiotics alter immune

responses but unclear if total immune function is altered.

Effects of Antibiotics upon the Gut Microbiome: A Review of the Literature discusses

how antibiotics affect the gut. While this article is not specific to pediatrics it provides a wealth

of information. Details regarding the microbiome varies from person-to-person country to

country as the article further explains that a healthy gut microbiome is highly diverse

(Konstantinidis et al., 2020). Multiple studies and research are presented with antibiotic effects

on humans as well as animals. This article is significant to my research question as it provides

great detail on the effects antibiotics have on infants and children. It explains the basic structures

also. By explaining how antibiotics create antimicrobial resistance globally it’s clear that

children are directly impacted as well.

A quantitative research article that I found in my research was Implementation and

impact of pediatric antimicrobial stewardship programs: a systematic scoping review. In this

article database analysis was completed of implemented ASPs for children ages 0-18yrs. Though

the study was observational the data proved that stewardship programs improved patient safety

and drug costs. This is significant to my research question as it provides data toward a solution to

end the overprescribing of antibiotics in children. Ensuring the proper distribution of antibiotics
 5

leads to improved patient care in the pediatric population and contributes to overall health

improvement in society generally.

Analysis

In the article mentioned above the predominately used methods of research were

quantitative and qualitative analysis. The use of quantitative data is used to present facts in the

way of numbers. I believe it was used in most of the research above because it provides a clear-

cut example of the facts. Numbers in research give a concrete explanation making it a popular

method of choice. Qualitative methods are used to present facts without numbers but with

examples. This choice is popular as it can give the readers a visual effect of the research

presented providing information through experiences. This method may be popular as not every

person understands numerical information and prefers words.

Major findings and conclusions identified in my research include the effects antibiotics

have on children in different ways. The first couple being the affects antibiotics have on active

immunity and the gut microbiome in children. I also identified that the overuse of antibiotics can

alter a child’s immune response when given to them at a young age. While I uncovered many

negative effects of antibiotics, I also discovered the implementation and significance of

stewardship programs to help stop the overuse of antibiotics in children. This is just as important

as knowing the negative effects as it provides a solution to remedy the misuse of antibiotics.

Gaps in research that I noticed were the lack of research on age ranges. Most of the above-

mentioned articles were specific to infants and children under the age of 2yrs old. I also feel

more research needs to be done to provide more information on overall effects on children and

not just one system at a time.

 6

Recommendations

Recommendations I have for future research based on my analysis are again to include a

broader age range and provide an overall evaluation of the effects of antibiotics on children

instead of one system at a time. I believe qualitative and quantitative are the best types of

research that are most beneficial in understanding my research question. They both provide data

in a way that is easy to understand and factual. Case studies could also be implemented more as

healthcare can be easily exemplified in them. A suggested title for a study could be Direct

impacts of antibiotics on children ages 0-18yrs. This title implies there may be a mix of both

qualitative and quantitative research on the topic. Steps to ensure the protection of human rights

include ensuring research is transparent and truthful. Also being unbiased, including diversity,

and maintaining integrity can protect human rights. Implications for nursing practice include the

effects caused by the study and possible adverse effects.

 7

Resources

Chapman, T. J., Pham, M., Bajorski, P., & Pichichero, M. E. (2022). Antibiotic Use and Vaccine

Antibody Levels. Pediatrics, 149(5). https://doi.org/10.1542/peds.2021-052061

Donà, D., Barbieri, E., Daverio, M., Lundin, R., Giaquinto, C., Zaoutis, T., & Sharland, M.

(2020). Implementation and impact of pediatric antimicrobial stewardship programs: a

systematic scoping review. Antimicrobial Resistance & Infection Control, 9(1).

https://doi.org/10.1186/s13756-019-0659-3

Gerber, J. S., Jackson, M. A., Tamma, P. D., & Zaoutis, T. E. (2020). Antibiotic Stewardship in

Pediatrics. Pediatrics, 147(1), e2020040295. https://doi.org/10.1542/peds.2020-040295

Konstantinidis, T., Tsigalou, C., Karvelas, A., Stavropoulou, E., Voidarou, C., & Bezirtzoglou,

E. (2020). Effects of Antibiotics upon the Gut Microbiome: A Review of the Literature.

Biomedicines, 8(11), 502. https://doi.org/10.3390/biomedicines8110502

Shekhar, S., & Petersen, F. C. (2020). The Dark Side of Antibiotics: Adverse Effects on the

Infant Immune Defense Against Infection. Frontiers in Pediatrics, 8.

https://doi.org/10.3389/fped.2020.544460