Antibiotic usage at a clinical paediatric hospital before and after the implementation of actions related to the hospital antibiotic policy.

OBJECTIVES: The aim of this study was to determine the impact of undertaken interventions related to the hospital antibiotic policy (antibiotic stewardship programme (ASP)): participation in a point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals (PPS ECDC), and Polish national programme to protect antibiotics (NPOA) on the modification of the amount and profile of antibacterial drug use at the Public Paediatric Teaching Clinical Hospital in Warsaw. METHODS: A retrospective analysis of antimicrobials (with daily defined doses (DDD) assignment) usage expressed in DDD and DDD/100 bed days (BD) in the period 2013-2017 (5 years) on 14 hospital wards at the Public Paediatric Teaching Clinical Hospital in Warsaw before and after the implementation of ASP-related actions was conducted. RESULTS: A total of 188 405.78 DDD were used and 553 485 paediatric BD were recorded in the wards selected for the present study in the period mentioned above. Wards with pre-authorisation duty for third-line antibiotics (group 1 of wards) used less DDD/100 BD (from 28.81 to 31.12 DDD/100 BD) than wards without such a duty (from 54.72 to 76.06 DDD/100 BD). We observed a temporary decrease of 6.37% in DDD/100 BD in group 1 of wards and a stable 9% to 21% decrease in DDD/100 BD tendency in group 2 of wards (wards without pre-authorisation duty: oncology, haematology and intensive care unit) compared with average values of DDD/100 BD in the period before ASP-related actions (2013-2014). Changes in drug utilisation (DU90%) profile were also observed, both positive and negative. CONCLUSIONS: More frequent actions related to ASP, such as annual PPS ECDC participation and regular personnel education on the principles of antibiotic therapy, should improve and make antimicrobial treatment more rational.