[Variability between health areas in antibiotic consumption among pediatric outpatients of Principado de Asturias, Spain (2005-2018)]. / Variabilidad entre áreas sanitarias en el consumo extrahospitalario de antibióticos de uso sistémico en la población pediátrica del Principado de Asturias, España (2005-2018).

OBJECTIVE: Antibiotics in Spain are mainly prescribed in the community sector, remarking a high variability between areas. The aim of this study is to describe the variability between health areas in the antibiotic consumption in the pediatric population of Asturias during 2005-2018 period. METHODS: Retrospective and comparative study using data about consumption of antibacterial agents for systemic use (J01C group in ATC, Anatomical Therapeutic Chemical, classification) in the pediatric outpatients of the eight health areas of Principado de Asturias between 2005 and 2018, based on defined daily dose (DDD) per 1000 inhabitants and day (DID). RESULTS: Mean antibiotic consumption in pediatric outpatients in Principado de Asturias (2005-2018) was 14 DID (CI95% 13.4 - 14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). ß-lactam penicillins was the most consumed therapeutic group (10.7 DID). There were statistically significant differences among the areas with the highest and the lowest consumption rates (Avilés, 19 DID; Oviedo, 11.5 DID). A high variability between health areas was observed when analysing data temporally (difference of 11.8 DID in 2011) and therapeutic groups. The consumption of macrolides in Langreo health area and quinolones in Jarrio health area were 2.3 and 4.1 times higher, respectively, comparing to Gijón health area. CONCLUSIONS: There is a wide quantitative and qualitative variability of antibiotic consumption in the pediatric outpatients among the different health areas of Asturias.

Características de los neonatos trasladados al hospital de referencia regional en Asturias / Characteristics of the newborns transferred to the regional reference hospital in Asturias

INTRODUCCIÓN: La regionalización de la asistencia neonatal es un punto importante de la asistencia pediátrica de calidad. Los traslados interhospitalarios neonatales forman parte de esta regionalización. OBJETIVO: Analizar las características de los neonatos trasladados al hospital de referencia en Asturias. MATERIAL Y MÉTODOS: Estudio observacional retrospectivo y descriptivo de los pacientes neonatales trasladados al Servicio de Neonatología del hospital regional de referencia, entre enero de 2017 y diciembre de 2018 en Asturias. RESULTADOS: Se incluyeron 136 pacientes (56 mujeres y 80 varones), lo que supone un traslado cada 5 días, el 1,8% de los neonatos nacidos en los hospitales emisores y el 14,4% de los ingresos en el hospital receptor. El 63,2% ingresaron en la unidad de cuidados intensivos y el 36,7% en la sala de cuidados intermedios, con un tiempo de ingreso medio de 9,5 días. El 20,7% eran prematuros. El peso medio al nacimiento fue de 2.983 g. La edad media al traslado fue de 5 días y el 46,3% de los traslados se realizaron durante las primeras 24 horas de vida. Las causas más frecuentes de traslado fueron: respiratorias (25%), neurológicas (14,7%), digestivas (13,2%) e infecciosas (12,5%). El 38% de los pacientes precisó soporte ventilatorio y el 1,4% falleció durante el ingreso. CONCLUSIONES: Los traslados neonatales interhospitalarios son relativamente frecuentes en nuestra región, siendo el distrés respiratorio y los problemas neurológicos las causas más comunes. El análisis de la regionalización de la asistencia neonatal resulta especialmente importante en regiones con escasa natalidad debido a la crisis demográfica

INTRODUCTION: Regionalization of neonatal care is an important point of quality in pediatric care. Neonatal interhospital transfers between regional hospitals and referral centers are part of this regionalization. OBJECTIVE: To analyze characteristics of newborns transferred from the different regional and private hospitals to theregional reference hospital in Asturias during 2017 and 2018. MATERIALS AND METHODS: An observational, descriptive and retrospective study was conducted, including all neonatal patients transferred fron other Asturian hospital to Neonatology Service of HUCA between January 2017 and December 2018, in Asturias. RESULTS: 136 patients were included (56 female and 80 male), which represents a transfer every 5 days, 1.8% of the 7,563 neonates born in the sending hospitals and 14.4% of the neonatal admissions in the receiving hospital. 63.2% of patients were admitted to the neonatal Intensive Care Unit and 36.7% to the neonatal Intermiediate care room with a mean admission time of 9.5 days. 20.7% were preterm newborns. The average born weight was 2,983 g. 20.6% were less than 2,500 g. Average age at transfer was 5 days, being the 46.3% made during first 24 hours of life. The most frequent causes of transfer were: respiratory (25%) neurological (14.7%), digestive (13.2%) and infectous (12.5%). 38% required ventilatory support and 1,4% died during admission. CONCLUSIONS: Neonatal inter-hospital transfers are relatively frequent in our region, with respiratory distress and neurological problems being the most common causes. The analysis of neonatal care regionalization is especially important in regions with low birth rates due to demographic crisis