Repository of Research and Investigative Information

Repository of Research and Investigative Information

Kurdistan University of Medical Sciences

The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children

(2016) The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children. Journal of Antimicrobial Chemotherapy.

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Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3; Asia, 13.0; Southern Europe, 9.8), cefepime (ranked third in North America, 7.8) and meropenem (ranked first in Latin America, 13.1). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9; range from 14.2 in Africa to 68.0 in Latin America) compared with children (28.3; range from 14.5 in Africa to 48.9 in Latin America). Parenteral administration was very common among children in Asia (88), Latin America (81) and Europe (67). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52). Prolonged surgical prophylaxis rates ranged from 78 (Europe) to 84 (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Item Type: Article
Keywords: amikacin; amoxicillin; ampicillin; azithromycin; cefazolin; cefepime; cefoperazone; ceforanide; cefotaxime; ceftazidime; ceftriaxone; cefuroxime; chloramphenicol; ciprofloxacin; clarithromycin; clindamycin; cloxacillin; cotrimoxazole; flucloxacillin; gentamicin; levofloxacin; meropenem; metronidazole; nalidixic acid; piperacillin; procaine penicillin; teicoplanin; tobramycin; unindexed drug; vancomycin; antiinfective agent, Africa; antibiotic resistance; antibiotic therapy; Article; Asia; Australia; child; clinical indicator; clinical practice; drug utilization; Europe; health survey; hospital admission; hospital infection; human; infection prevention; medical documentation; newborn; North America; prescription; prevalence; South and Central America; cross-sectional study; drug utilization; female; global health; health care quality; health care survey; hospital; infant; male; preschool child; prescription; standards; statistics and numerical data, Anti-Bacterial Agents; Child; Child, Preschool; Cross-Sectional Studies; Drug Prescriptions; Drug Resistance, Microbial; Drug Utilization; Europe; Female; Global Health; Health Care Surveys; Hospitals; Humans; Infant; Male; Prevalence; Quality Indicators, Health Care
Page Range: pp. 1106-1117
Journal or Publication Title: Journal of Antimicrobial Chemotherapy
Volume: 71
Number: 4
Publisher: Oxford University Press
Identification Number: 10.1093/jac/dkv418
ISSN: 03057453
Depositing User: مهندس جمال محمودپور

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