Antibiotic utilisation in adult and children patients in Kosovo hospitals

Krasniqi, Shaip; Versporten, Ann; Jakupi, Arianit; Raka, Denis; Daci, Armond; Krasniqi, Valon; Deva, Zana; Rashiti, Albiona; Brajshori, Naime; Hajdari, Shefqet; Bytyqi, Jetëmira; Neziri, Burim; Goossens, Herman; Raka, Lul

doi:10.1136/ejhpharm-2017-001363

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Consistent with most study results [ 17 , 21 , 23 – 25 ], our analysis shows that third-generation cephalosporin was the most commonly prescribed antibiotic in this study population. In principle, the use of broad-spectrum antibiotics is caused by a concern regarding the possibility of bacterial etiology.…”

Section: Discussionsupporting

confidence: 92%

Analysis of antibiotic treatment of children in a Shanghai tertiary hospital based on point prevalence surveys

Gao

Guo

et al. 2020

BMC Infect Dis

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Background Misuse and overuse of antibiotics by physicians in the treatment of children is common in China. This study aimed to reveal the overall use of antibiotics to treat children hospitalized in four types of pediatric wards. Methods Seven independent point prevalence surveys (PPSs) were conducted in Shanghai Children’s Hospital of Shanghai Jiao Tong University over the period 2012 to 2018. Pediatric ward types were defined general pediatric medical, pediatric surgical, pediatric intensive care units (PICU), and neonatal. Results A total of 3975 pediatric patients were included in the study, of which 63.9% received at least one dose antibiotic. The top five classes of antibiotics administered were cephalosporins (43.8%, n = 1743), penicillins (13.2%, n = 526), carbapenems (8.7%, n = 347), nitroimidazoles (7.1%, n = 281) and macrolides (6.5%, n = 257). The five most commonly used generic antibiotics were cefuroxime (14.9%, n = 594), ceftriaxone (9.7%, n = 387), cefotaxime (9.0%, n = 358), meropenem (8.1%, n = 320) and ampicillin/sulbactam (6.0%, n = 239). Meropenem was among top five antibiotics prescribed in the general pediatric, PICU and neonatal wards and sixth in the pediatric surgical wards. Of all children on antibiotics, 23.4% received prophylactic treatment, and prophylaxis accounted for 68.1% of indications for treatment in the pediatric surgical wards. Conclusions Given that over-treatment with third-generation cephalosporins and carbapenems has been associated with treatment-resistant infections, the prescription of these drugs should be strictly controlled and monitored, and measures should be taken to improve the management of surgical prophylaxis in hospitalized children in China.

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Section: Discussionsupporting

confidence: 92%

Analysis of antibiotic treatment of children in a Shanghai tertiary hospital based on point prevalence surveys

Gao

Guo

et al. 2020

BMC Infect Dis

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“…According to the survey results conducted through these initiatives, Kosovo had the highest share of total parenteral consumption of ceftriaxone in Europe in 2013 (53.9 DID) [ 16 ]. Another related survey, showed that use of antibiotics in children in Kosovo hospitals is very high compared to most European countries [ 17 ]. Moreover, one survey performed at primary health care facility in Kosovo shows that parents’ knowledge, attitude and use of antibiotics in their children is not appropriate [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of parents’ attitudes and practices related to antibiotic use for their children in Kosovo: a cross-sectional survey

Imeri,

Krasniqi,

Raka

et al. 2023

J of Pharm Policy and Pract

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Background Self-medication and lack of patient adherence contribute to antibiotic misuse. This article describes parents’ attitudes and practices regarding use of antibiotics by their children in Kosovo. Methods A cross-sectional survey was conducted during data collection. We surveyed a total of 453 parents of children aged 0–15 years, who had experiences with using antibiotics for their children. Correlation tests and regression analysis were used to explore the relationship between variables. Results Our findings showed that 42.2% of parents strongly agreed or agreed with the use of antibiotics as a means to cure a cold or flu in their child more quickly. In addition, 29.8% were not aware of antibiotic side effects. Non-compliance with antibiotic treatment was 35.8%, and 28.9% of surveyed parents suggested that they had pressured their pediatricians to prescribe antibiotics for their children. A total of 10.15% of parents had no information on antibiotic resistance, and 34.38% of parents responded that they did not believe that self-medication with antibiotics could lead to resistance. Regression analysis results indicated that gender and age group have a significant influence on the parents’ decision that an antibiotic should be used in children with high fever (p < 0.001). Conclusions Our findings suggest that antibiotic management by parents in Kosovo is not satisfactory, and more attention should be given to their knowledge of the side effects of antibiotics, bacterial resistance and reduction in the self-medication. Health education, adequate measures and interventions are needed to overcome this situation and ensure rational use of antibiotics in Kosovo.

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Antibiotic use in pediatric acute care hospitals: an analysis of antibiotic consumption data from Germany, 2013–2020

Freudenhammer,

Hufnagel,

Steib-Bauert

et al. 2023

Infection

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Background Antimicrobial stewardship (AMS) programs are effective tools for improving antibiotic prescription quality. Their implementation requires the regular surveillance of antibiotic consumption at the patient and institutional level. Our study captured and analyzed antibiotic consumption density (ACD) for hospitalized pediatric patients. Method We collected antibacterial drug consumption data for 2020 from hospital pharmacies at 113 pediatric departments of acute care hospitals in Germany. ACD was calculated as defined daily dose (DDD, WHO/ATC Index 2019) per 100 patient days (pd). In addition, we analyzed the trends in antibiotic use during 2013–2020. Results In 2020, median ACD across all participating hospitals was 26.7 DDD/100 pd, (range: 10.1–79.2 DDD/100 pd). It was higher at university vs. non-university hospitals (38.6 vs. 25.2 DDD/100 pd, p < 0.0001). The highest use densities were seen on oncology wards and intensive care units at university hospitals (67.3 vs. 38.4 DDD/100 pd). During 2013–2020, overall ACD declined (− 10%) and cephalosporin prescriptions also decreased (− 36%). In 2020, cephalosporins nevertheless remained the most commonly dispensed class of antibiotics. Interhospital variability in cephalosporin/penicillin ratio was substantial. Antibiotics belonging to WHO AWaRe “Watch” and “Reserve” categories, including broad-spectrum penicillins (+ 31%), linezolid (+ 121%), and glycopeptides (+ 43%), increased over time. Conclusion Significant heterogeneity in ACD and prescription of different antibiotic classes as well as high prescription rates for cephalosporins and an increased use of reserve antibiotics indicate improvable antibiotic prescribing quality. AMS programs should urgently prioritize these issues to reduce antimicrobial resistance.

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Antibiotic utilisation in adult and children patients in Kosovo hospitals

Cited by 5 publications

References 30 publications

Analysis of antibiotic treatment of children in a Shanghai tertiary hospital based on point prevalence surveys

Analysis of antibiotic treatment of children in a Shanghai tertiary hospital based on point prevalence surveys

Evaluation of parents’ attitudes and practices related to antibiotic use for their children in Kosovo: a cross-sectional survey

Antibiotic use in pediatric acute care hospitals: an analysis of antibiotic consumption data from Germany, 2013–2020

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