Appropriateness of antibiotic prescribing in paediatric patients in a hospital emergency department

Santander, Borja Croche; Alonso, Elena Campos; Carrión, Adela Sánchez; Fuentes, Laura Marcos; Flores, Isabel Diaz; Vargas, Juan Carlos; Domínguez, Bárbara Fernández; Ibañez, Cristóbal Toro

doi:10.1016/j.anpede.2017.06.002

Cited by 15 publications

(17 citation statements)

References 31 publications

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“…Según estos estudios previos, se considera que entre el 20% y el 50% de las prescripciones antibióticas en el paciente hospitalizado son inapropiadas o innecesarias [16]. Otros trabajos realizados en esta área demuestran, además, que la no adherencia a guías de práctica clínica, el uso de antimicrobianos con un espectro más amplio del necesitado y la duración excesiva de tratamientos son frecuentes [6,7].…”

Section: Discussionunclassified

“…Según la Organización Mundial de la Salud (OMS), la no adherencia a las guías de práctica clínica y la prescripción indiscriminada de antibióticos de espectro mayor al necesitado son dos de las primeras causas de aparición de resistencias antimicrobianas, ya consideradas como un problema de salud pública a nivel mundial [2,3]. Además, el uso inadecuado de antimicrobianos se relaciona con una mayor incidencia de fracaso terapéutico, un aumento de la morbimortalidad y una utilización ineficiente de los recursos [4][5][6]. La Sociedad Americana de Enfermedades Infecciosas (IDSA) recomienda la implementación de guías de tratamiento empírico adaptadas a la ecología local de cada centro para evitar la aparición de resistencias y como herramienta para disminuir la morbimortalidad, la estancia hospitalaria y los costes sanitarios [7].…”

Section: Introductionunclassified

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Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

Osorio¹,

Fresco²,

Monclús³

et al. 2020

Rev Esp Quimioter

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Objective. The aim of the study was to analyze the adequacy of the special category antibiotics prescriptions in the Emergency Department (ED) of a third level urban Hospital. Material and methods. A random sample of 100 different patients who were started with a special category antibiotic along 2018 in the ED was selected. The research team reviewed the medical history of the emergency and admission episode. The independent factors associated with the degree of adequacy of the treatment were determined by logistic regression. Results. A total of 97 prescriptions were analyzed of which 66 (68%) met the criteria of adequate prescription, 23 (24%) adequate prescription, but with equally recommended alternatives and 8 (8%) were inappropriate prescriptions. The degree of adequacy was 70% if the infection was related to healthcare and 75% if the patient had risk factors for multiresistant (MR) microorganisms' infection. The percentage of adequacy was higher in the cases in which the focus of the infection (72%) and the severity of the episode (73%) were specified. The independent variables that were associated with an adequate prescription were: the presence of risk factors for MR microorganisms' infection (OR: 2.35 95% CI: 1.65-3.17 p: 0.01), if the focus of the infection (OR: 3.79 95% CI: 1.72-4.22 p: 0.02) and the severity of the episode (OR: 3.09 95% CI: 1.12-3.09 p: 0.03) were specified. Conclusions. The prescription of special category antibiotics in ED is appropriate if the clinical guidelines are followed and if the setting of infection acquisition, the risk factors of MR microorganisms, the focus and the severity of infection are taken into account in clinical picture.

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Section: Discussionunclassified

Section: Introductionunclassified

Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

Osorio¹,

Fresco²,

Monclús³

et al. 2020

Rev Esp Quimioter

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“…[14][15][16] It was more as compared to studies done in Latvia (26-38%), Brazil (24.4%) and Spain (16.5%). [17][18][19] Study done in USA was a very large study which showed percentage of antibiotic use of 38-72% in different states of USA with mean use of 60%. 20 On comparing our study with similar Indian studies (from Andhra Pradesh, Puducherry and Kolkata percentage of encounter with antibiotic was 50.05, 60 and 79.82% respectively), our antibiotic usage was quite less.…”

Section: Discussionmentioning

confidence: 99%

Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

Jeeyani

Parikh

Sivanandan

et al. 2020

Int J Contemp Pediatr

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Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

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“…параты в педиатрии, и большая часть назначений прихо-дится именно на ОРВИ (78,4%), что под собой не имеет никакой основы [5,6].…”

Section: бронхопульмонология и лорunclassified

“…Кроме того, в 35,2% случаев был сде-лан неправильный выбор антибиотика, а в 24,1% -реко-мендована неверная доза. Наиболее частыми диагноза-ми с ошибочным назначением антибиотиков были ОСО, бронхообструктивный синдром, лихорадка без очага инфекции, ОТ и пневмония [6].…”

Section: бронхопульмонология и лорunclassified

Acute Tonsillitis in Children: The Principle “Zap and It’s Done!”?

et al. 2018

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Appropriateness of antibiotic prescribing in paediatric patients in a hospital emergency department

Cited by 15 publications

References 31 publications

Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

Adequacy of the special category antibiotics prescriptions in the Emergency Department of a third level urban Hospital

Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

Acute Tonsillitis in Children: The Principle “Zap and It’s Done!”?

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