Measuring antibiotic prescribing in hospitalised children in resource‐poor countries: A systematic review

Abstract

Antibiotic resistance represents a significant threat to global health. Widespread exposure to antibiotics drives the development of antibiotic resistance. Little is known about the exposure to antibiotics of hospitalised children, particularly in resource-poor countries where the burden of infectious disease is highest. The review sought to identify original research quantifying antibiotic use in hospitalised children in resource countries. The methods used were: A systematic search of the MEDLINE, CINAHL, EMBASE, LILACS and African Index Medicus databases. Eighteen papers were identified and the methodology varied considerably. Only seven used a recognised defined daily dose (DDD) methodology. The studies reveal a high exposure of hospitalised children to antibiotics. With the exception of data from China, the studies were limited by their design. Limited evidence of the variation in drug, dose and total exposure to antibiotic use in hospitalised children in resource-poor countries exists. An international network of surveillance of both antimicrobial prescribing and resistance using a simple standardised methodology in this context remains an important goal. A simplified paediatric version of the adult DDD methodology is required to allow international comparison between populations.

Interventions to reduce childhood antibiotic prescribing for upper respiratory infections: systematic review and meta-analysis

“…Previous systematic reviews were conducted to explore the effectiveness of interventions to reduce irrational antibiotic prescription in adults and children with various diseases 4 5 8 22–25. The advantages of our review over others are that we focus on a specific population (children) and condition (URI) and stratified analyses according to the type of intervention, which enriched the existing literature as most of the previous studies were descriptive.…”

“…Nevertheless, prescribing antibiotics for childhood URIs is highly prevalent 4. Antibiotic resistance is frequently observed in young children and more invasive infections occur in this vulnerable population 5. In Asia, every 2 min a child aged under 5 years dies from antibiotic-resistant infections 6…”

Impact of clinical decision support on empirical antibiotic prescribing for children with community‐acquired pneumonia

“…Similar assessments of CDSS impact on overall antimicrobial consumption in our hospital has been limited by a lack of feasible and widely accepted measures to monitor use in paediatrics . Unlike adult hospitals without electronic prescribing or administration records, there is no paediatric equivalent for the World Health Organization's defined daily dose for adults . As a result, the CDSS is often used by the local AMS to monitor antimicrobial use.…”

First point prevalence survey of neonatal and pediatric antibiotic prescribing in a secondary care hospital in Macedonia

“…A systematic review of the available literature by Irwin and Sharland identified eighteen studies and revealed high exposure of hospitalised children to antibiotics [9]. Naughton et al compared PPS data from four regional/general hospitals in Ireland and identified 29% to 37% of paediatric and neonatal patients on antibiotics.…”