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• W4233485136 abstract "Information about paediatric in-hospital antimicrobial usage and prescribing patterns to guide improvement strategies is scant. We aim to use an evaluation of the prevalence and appropriateness of antimicrobial prescription to identify antimicrobial stewardship priorities in children. A cross-sectional point study was performed on hospitalised paediatric patients in a Spanish tertiary hospital, assessing the prevalence of antimicrobial prescription (PAP) and appropriateness of antimicrobial prescription (AAP). AAP was defined as a correct indication plus an appropriate prescribing pattern (dose, spectrum and interval). Evaluation was performed using established antimicrobial guidelines. Other factors that may have a bearing on antimicrobial prescription were also analysed. A total of 171 patients were included. PAP was 49.7% (85/171) and AAP was 60.9% (91/161). The most common indications for antimicrobial use were antimicrobial prophylaxis (28.3%, 32/113) and pneumonia (8.2%, 8/113). Overall, 161 antimicrobials were prescribed (1.9 antimicrobials per patient): 55.3% (89/161) were empiric, 16.1% (26/161) were targeted and 28.6% (46/161) were prophylactic. Amoxicillin/clavulanate (8.2%, 14/171) and sulfamethoxazole/trimethoprim (8.2%, 14/171) were the most prescribed antimicrobials. The prescription of antifungals (11.7%, 20/171) and antivirals (1.8%, 3/171) was analysed. Major causes of inappropriate antibiotic use were prolonged prescriptions (21.7%, 35/161) and use of agents with an excessively broad coverage spectrum (21.1%, 34/161). PAP and AAP varied between wards and antimicrobials. Measurement of PAP and AAP offers valuable information for detecting priorities in hospital settings and monitoring antimicrobial usage prior to the development of antimicrobial stewardship programmes. In our setting, the main areas for improvement are duration of therapy and proper use of broad-spectrum antimicrobials. La información sobre el uso hospitalario de antimicrobianos en pediatría para orientar estrategias de mejora es escasa. Proponemos utilizar la evaluación de prevalencia y adecuación de la prescripción antimicrobiana para identificar prioridades en programas de optimización de uso de antimicrobianos en niños. Se realizó un estudio de corte transversal en niños hospitalizados en un centro terciario español evaluando la prevalencia de prescripción antimicrobiana (PPA) y la proporción de adecuación en prescripción antimicrobiana (PAA). Se definió la PAA como una correcta indicación más un apropiado patrón de prescripción del antimicrobiano (dosis, espectro e intervalo) según guías establecidas. Se analizaron también otros factores con influencia potencial en prescripción. Se incluyeron 171 pacientes, obteniendo una PPA = 49,7% (85/171) y PAA = 60,9% (91/161). Profilaxis antimicrobiana (28,3%, 32/113) y neumonía (8,2%, 8/113) fueron las indicaciones más frecuentes. Se realizaron 161 prescripciones antimicrobianas (1,9 antimicrobianos por paciente): 55,3% (89/161) empíricas; 16,1% (26/161) dirigidas y 28,6% (46/161) profilácticas. Amoxicilina/ácido clavulánico (8,2%, 14/171) y trimetoprim/sulfametoxazol (8,2%, 14/171) fueron los antimicrobianos más prescritos. Se analizó la prescripción antifúngica (11,7%, 20/171) y antiviral (1,8%, 3/171). Las principales causas de uso inapropiado de antibióticos fueron el uso prolongado (21,7%, 35/161) y espectros de cobertura demasiado amplios (21,1%, 34/161). La PPA y PAA variaron según área de hospitalización y antimicrobianos. La PPA y PAA ofrecen información valiosa para detectar prioridades en hospitales previamente al desarrollo de programas de optimización de uso de antimicrobianos y monitorizar el uso de antimicrobianos. En nuestro centro la duración del tratamiento y el espectro antimicrobiano excesivo fueron las principales áreas a mejorar." @default.
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• W4233485136 date "2017-11-01" @default.
• W4233485136 modified "2023-10-18" @default.
• W4233485136 title "Identifying priorities to improve paediatric in-hospital antimicrobial use by cross-sectional evaluation of prevalence and appropriateness of prescription" @default.
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• W4233485136 doi "https://doi.org/10.1016/j.eimce.2017.01.038" @default.
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