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CONCLUSION: The frequency of laparotomy or laparoscopy in children with BLSI was 8.2%. Children with no clinical signs of bleeding upon arrival did not later bleed, but 1.6% of these patients ultimately required abdominal surgery for other injuries. Transfusion >40mL/kg was strongly associated with intervention or death, but a substantial number of children who received less blood also required intervention.

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CONCLUSION: The bundle of interventions decreased but did not eliminate the interaction. With the interaction as an independent risk factor for resistance and increasing use of oral antibiotics, stewardship programmes should consider implementing similar interventions.