Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil

Silva, André Ricardo Araújo da; Jaszkowski, Elena; Schober, Tilmann; Both, Ulrich von; Meyer-Buehn, Melanie; Marques, Amanda; Farkas, Beatriz; Abreu, Bernardo Silva de; Biase, C Biscaia di; Takahashi, Jully Miyoshi; Castro, Luisa Dutra de; Leal, Izabel Alves; Teixeira, Cristiane Henriques; Nußbaum, Claudia; Hoffmann, Florian; Hübner, Johannes

doi:10.1007/s10096-019-03714-9

Cited by 12 publications

(14 citation statements)

References 15 publications

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“…A similar observation was also reported by Al-Turkait et al [24]. Because neonatal sepsis could negatively impact mortality, many physicians are sometimes hesitant to discontinue antibiotic administration despite improvement in infection symptoms or clinical appearance [24,25].…”

Section: Discussionsupporting

confidence: 67%

Evaluation of antibiotic prescriptions for sepsis in the Neonatal Intensive Care Unit in a Tertiary Hospital in North Sumatera, Indonesia

Pasaribu¹,

Syofiani²,

Fahmi³

et al. 2021

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Background. Neonatal sepsis is a leading cause of morbidity and mortality worldwide. The evaluation of antibiotic prescription in neonatal intensive care units (NICUs) is important for reducing inappropriate antibiotic use and minimizing the development of antibiotic resistance. Antimicrobial stewardship programs potentially promote a prudent use of antibiotics; however, the approach in NICUs is not yet optimal. Objectives. The aim of our study was to evaluate antibiotic prescriptions for neonatal sepsis in a tertiary hospital in North Sumatera, indonesia. Material and methods. In our retrospective study, we collected data from medical records and enrolled 324 neonatal sepsis patients who received one or more antibiotics. Results. Gentamycin and cefotaxime were the two most common antibiotics prescribed in the NICU (72.22% and 71.60%, respectively). However, high levels of resistance to gentamycin and cefotaxime were found among common pathogens circulating in the NICU (55.56% and 82.81%, respectively). Only 40.33% of the antibiotic prescriptions were appropriate: approximately 15.11% of the patients had received antibiotics with incorrect indications and 16.16% of the antibiotics had been administered without sufficient duration. Conclusions. The appropriate use of antibiotic prescriptions in the NICU was low, which may lead to high mortality in neonatal sepsis patients. Continued evaluation of antibiotic usage by implementing antimicrobial stewardship programs in the NICU is important.

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Section: Discussionsupporting

confidence: 67%

Evaluation of antibiotic prescriptions for sepsis in the Neonatal Intensive Care Unit in a Tertiary Hospital in North Sumatera, Indonesia

Pasaribu¹,

Syofiani²,

Fahmi³

et al. 2021

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“…The studies were conducted in 26 countries ( Figure 2) with India and the United States of America (USA) accounting for the largest number of reports, 14 and 13 respectively. There was one study that involved several European countries (21 participated) [65] and one study conducted in Germany and Brazil [66]. drugs received by infants born at 22-24 weeks gestational age only.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

Al-Turkait

Szatkowski

Choonara

et al. 2020

IJERPH

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Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

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“…Glycopeptide use among PICUs (98 DOT/1000pd) was more than three-times higher than glycopeptide use among non-ICU wards (30 DOT/1000pd); this is likely due in part to more frequent use of central lines and coverage for coagulase negative staphylococci on PICUs. Glycopeptide use among PICUs in this study was similar to use on a German PICU (90 DOT/1000pd) [ 56 ], but lower than Brazilian, Saudi Arabian and South African PICUs (151 to 263 DOT/1000pd) [ 52 , 54 – 56 ]. Differences in glycopeptide use may be partially due to differences in rates of methicillin-resistant Staphylococcus aureus across jurisdictions [ 56 ].…”

Section: Discussionmentioning

confidence: 69%

“…A 2015 study of AMU among a PICU in South Africa reported a rate of 1336 DOT/1000pd [ 52 ]. A study of German and Brazilian PICUs found rates of 888 and 1441 DOT/1000pd, respectively; patients with < 24 h of AMU were excluded in this study [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial use among paediatric inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program, 2017/2018

Rudnick

Conly

Thirion

et al. 2023

Antimicrob Resist Infect Control

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Background Antimicrobial resistance threatens the ability to successfully prevent and treat infections. While hospital benchmarks regarding antimicrobial use (AMU) have been well documented among adult populations, there is less information from among paediatric inpatients. This study presents benchmark rates of antimicrobial use (AMU) for paediatric inpatients in nine Canadian acute-care hospitals. Methods Acute-care hospitals participating in the Canadian Nosocomial Infection Surveillance Program submitted annual AMU data from paediatric inpatients from 2017 and 2018. All systemic antimicrobials were included. Data were available for neonatal intensive care units (NICUs), pediatric ICUs (PICUs), and non-ICU wards. Data were analyzed using days of therapy (DOT) per 1000 patient days (DOT/1000pd). Results Nine hospitals provided paediatric AMU data. Data from seven NICU and PICU wards were included. Overall AMU was 481 (95% CI 409–554) DOT/1000pd. There was high variability in AMU between hospitals. AMU was higher on PICU wards (784 DOT/1000pd) than on non-ICU (494 DOT/1000pd) or NICU wards (333 DOT/1000pd). On non-ICU wards, the antimicrobials with the highest use were cefazolin (66 DOT/1000pd), ceftriaxone (59 DOT/1000pd) and piperacillin-tazobactam (48 DOT/1000pd). On PICU wards, the antimicrobials with the highest use were ceftriaxone (115 DOT/1000pd), piperacillin-tazobactam (115 DOT/1000pd), and cefazolin (111 DOT/1000pd). On NICU wards, the antimicrobials with the highest use were ampicillin (102 DOT/1000pd), gentamicin/tobramycin (78 DOT/1000pd), and cefotaxime (38 DOT/1000pd). Conclusions This study represents the largest collection of antimicrobial use data among hospitalized paediatric inpatients in Canada to date. In 2017/2018, overall AMU was 481 DOT/1000pd. National surveillance of AMU among paediatric inpatients is necessary for establishing benchmarks and informing antimicrobial stewardship efforts.

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Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil

Cited by 12 publications

References 15 publications

Evaluation of antibiotic prescriptions for sepsis in the Neonatal Intensive Care Unit in a Tertiary Hospital in North Sumatera, Indonesia

Evaluation of antibiotic prescriptions for sepsis in the Neonatal Intensive Care Unit in a Tertiary Hospital in North Sumatera, Indonesia

Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

Antimicrobial use among paediatric inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program, 2017/2018

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