Antibiotic Prescribing Pattern in Neonates of Seventeen Iranian Hospitals

Fahimzad, Alireza; Eydian, Zahra; Karimi, Abdollah; Shiva, Farideh; Armin, Shahnaz; Ghanaei, Roxana Mansour; Fallah, Fatemeh; Tabatabaei, Sedigheh Rafiei; Shirvani, Fariba; Rahbar, Mohammad; Sayyahfar, Shirin; Kahbazi, Manijeh; Rahbarimanesh, A A; Arjmand, Reza; Dashti, Anahita Sanaei; Abdinia, Babak; Abedini, Masomeh; Hidari, H; Ghadiri, Keyghobad; Sharif, Aminsadat; Shahri, Elham Shafighi; Shariat, Zeynab; Nejadian, Ali; Moshayedi, Mona; Fatholahpoor, Samaneh; Alizadeh, Hamid; Heravi, Reza Entezari

doi:10.5812/pedinfect.61630

Cited by 7 publications

(13 citation statements)

References 20 publications

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“…This study showed that the rates of antibiotic uses were high in the pediatric and neonatal wards of two tertiary teaching hospitals located in two different provinces of Iran (61% and 71%, respectively), which is consistent with two multicenter studies from Iran (8,9). This rate in hospitalized children was significantly higher in the BTH (72%) than in the NTH (56%; P =0.03).…”

Section: Discussionsupporting

confidence: 89%

“…Such variations may be partly due to differences in hospital systems and patients. Next, in a recent study from Iran, the rate of antibiotic use was high (66.6%), compared to other countries (8,9). As reported, a more frequent and inappropriate use of antibiotics has contributed to higher levels of emerging antimicrobial resistance (20,21).…”

Section: Discussionmentioning

confidence: 91%

“…This rate in hospitalized children was significantly higher in the BTH (72%) than in the NTH (56%; P =0.03). A wide range of antibacterial use determined in different hospitals ranged from 32.9% to 100% in pediatric wards and 21.4% to 100% in neonatal wards in Iran (8,9). These variations could be explained by the characteristics of hospital care systems and the case mix.…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Fahimzad et al, antibiotic use in Iranian hospitalized children was 66.6% (8). In another study, the frequency of antibiotic prescribing in neonatal wards was reported as 72.1% (9).…”

Section: Introductionmentioning

confidence: 96%

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Point Prevalence Survey of Antimicrobial Prescription and Infection in Pediatric and Neonatal wards of Two Iranian Teaching Hospitals

Soltani¹,

Pouladfar²,

Versporten³

et al. 2018

Erciyes Med J

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Point Prevalence Surveys (PPSs) provide useful data on the patterns of in-hospital antimicrobial prescription. Aiming to identify targets for quality improvement, we evaluated prescribing patterns of antimicrobials in the pediatric and neonatal wards of two tertiary referral centers in Iran. Materials and Methods: Two PPSs on antimicrobial use in children and neonates hospitalized in the Nemazee teaching hospital in Shiraz (south of Iran) and Besat teaching hospital in Sanandaj (west of Iran) were performed for two consecutive years. We used a validated and standardized method based on the Antibiotic Resistance and Prescribing in European Children project. Results: Out of a total of 266 and 129 admissions in pediatric and neonatal wards, respectively, 61% of pediatric inpatients and 71% of neonates received at least one antimicrobial. The most frequently prescribed antibiotics in pediatric wards were ceftriaxone (29.2%) and vancomycin (15%), and in neonatal wards, ampicillin (34.7%) and cefotaxime (14.7%). Antimicrobial combination therapies and the parenteral route of administration in pediatric wards were 40% and 91.3%, and in neonatal wards, 63% and 100%, respectively. Empirical antibiotic therapies in pediatric and neonatal wards were 93.6% and 96%, respectively. Conclusion: The high percentage of antimicrobial use, combination therapies, and empirical therapies could be the targets for quality improvement in our hospitals.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Point Prevalence Survey of Antimicrobial Prescription and Infection in Pediatric and Neonatal wards of Two Iranian Teaching Hospitals

Soltani¹,

Pouladfar²,

Versporten³

et al. 2018

Erciyes Med J

View full text Add to dashboard Cite

show abstract

“…This result is in contrast to other studies [24,28,49,50,51,52]. Several studies have reported high rate of irrational antibiotic prescription and a significant percentage of them were empirically prescribed for patients [26,41,53,54].…”

Section: Discussionmentioning

confidence: 65%

Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

Paul

Abdulmalik

2019

JAMMR

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Background: Resistance to antibiotics is spreading rapidly around the world with its associated morbidity and mortality. Infections are becoming increasingly difficult to treat resulting in increased cost of medical care. In low income countries with high infectious disease burden, antibiotic resistance is reported to be accelerated by irrational prescriptions in health facilities. In the absence of adequate resources, many clinicians engage in empirical antibiotic prescriptions some of which their appropriateness is questionable. There is need for laboratory evidence to justify empirical antibiotic use in the light of increasing resistance to commonly prescribed antibiotics. Aims: This study aims to determine empirical antibiotic prescription pattern and to determine rationality using resistance profile of common bacterial isolates in hospitals. Methods: Antibiotic prescriptions in the NHIS department and antibiogram records were obtained from pharmacy and laboratory records respectively. Analysis was carried out using descriptive statistics and comparison between antibiotics prescribed and their respective resistance pattern were compared to determine rationality. Results and Discussion: The Penicillins and Quinolones were the most prescribed class of antibiotics and resistance range between 30 – 90% and 3 – 23% respectively. Resistance to other antibiotics was high thus making empirical prescriptions irrational in most of the cases. These findings have been consistently reported in several studies so widespread empirical antibiotic prescriptions are not in tandem with principles of rational drug use. Conclusion: Antibiotic resistance is common among hospital isolates, so there is need to emphasize that prescriptions be based on laboratory evidence of microbial sensitivity.

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Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Hsia

Lee

Versporten

et al. 2019

The Lancet Global Health

263

197

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Background Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings Of the 23 572 patients included from 56 countries, 18 305 were children (77•7%) and 5267 were neonates (22•3%). Access antibiotic use in children ranged from 7•8% (China) to 61•2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77•3%) and lowest in Finland (23•0%). In neonates, Access antibiotic use was highest in Singapore (100•0%) and lowest in China (24•2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index.

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Antibiotic Prescribing Pattern in Neonates of Seventeen Iranian Hospitals

Cited by 7 publications

References 20 publications

Point Prevalence Survey of Antimicrobial Prescription and Infection in Pediatric and Neonatal wards of Two Iranian Teaching Hospitals

Point Prevalence Survey of Antimicrobial Prescription and Infection in Pediatric and Neonatal wards of Two Iranian Teaching Hospitals

Empirical Antibiotic Prescription Pattern among Patients in a Nigerian Tertiary Hospital, is There Evidence of Irrationality?

Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

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