Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital.
Med J Aust
; 201(11): 657-62, 2014 Dec 11.
Article
em En
| MEDLINE
| ID: mdl-25495311
ABSTRACT
OBJECTIVES:
To describe antimicrobial use in hospitalised Australian children and to analyse the appropriateness of this antimicrobial use.DESIGN:
Multicentre single-day hospital-wide point prevalence survey, conducted in conjunction with the Antimicrobial Resistance and Prescribing in European Children study.SETTING:
Eight children's hospitals across five Australian states, surveyed during late spring and early summer 2012. PATIENTS Children and adolescents who were inpatients at 8 am on the day of the survey. MAIN OUTCOMEMEASURES:
Quantity and quality of antimicrobial prescribing.RESULTS:
Of 1373 patients, 631 (46%) were prescribed at least one antimicrobial agent, 198 (31%) of whom were < 1 year old. The highest antimicrobial prescribing rates were in haematology and oncology wards (76% [95/125]) and paediatric intensive care units (55% [44/80]). Of 1174 antimicrobial prescriptions, 550 (47%) were for community-acquired infections, 175 (15%) were for hospital-acquired infections and 437 (37%) were for prophylaxis. Empirical treatment accounted for 72% of antimicrobial prescriptions for community-acquired infections and 58% for hospital-acquired infections (395 and 102 prescriptions, respectively). A total of 915 prescriptions (78%) were for antibacterials; antifungals and antivirals were predominantly used for prophylaxis. The most commonly prescribed antibacterials were narrow-spectrum penicillins (18% [164 prescriptions]), ß-lactam-ß-lactamase inhibitor combinations (15% [136]) and aminoglycosides (14% [128]). Overall, 957 prescriptions (82%) were deemed appropriate, but this varied between hospitals (range, 66% [74/112]) to 95% [165/174]) and specialties (range, 65% [122/187] to 94% [204/217]). Among surgical patients, 65 of 187 antimicrobial prescriptions (35%) were deemed inappropriate, and a common reason for this was excessive prophylaxis duration.CONCLUSION:
A point prevalence survey is a useful cross-sectional method for quantifying antimicrobial use in paediatric populations. The value is significantly augmented by adding assessment of prescribing quality.
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Base de dados:
MEDLINE
Assunto principal:
Prescrição Inadequada
/
Anti-Infecciosos
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Humans
País como assunto:
Oceania
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article