Trends in Antibacterial Use in Hospitalized Pediatric Patients in United States Academic Health Centers

Pakyz, Amy; Gurgle, Holly E.; Ibrahim, Omar; Oinonen, Michael; Polk, Ronald E.

doi:10.1086/597545

Cited by 48 publications

(36 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 Similar to our study, the most commonly used antibacterial classes were beta-lactamase labile penicillins, aminoglycosides, third-generation cephalosporins, and glycopeptides. Although the patient population was not similar between the 2 studies, they showed that DOT per 1000 patientdays is a useful tool and allows solid benchmarking.…”

Section: Discussionsupporting

confidence: 78%

“…One DOT represents the administration of a single agent on a given day, regardless of the number of doses administered or dosage strength. 21,24,25 These data were normalized to 1000 patient-days. In addition, we defined TD as days with an antibiotic treatment, irrespective of the number of antibiotics administered on the same day.…”

Section: Antibiotic Usementioning

confidence: 99%

“…18 -20 Only few data on antibiotic consumption, in particular time trends of antibiotic use, are available for neonates. 21 The purpose of this study was to assess time trends in antibiotic consumption in the context of the introduction of an antibiotic policy and the possible effect of antibiotic use on antimicrobial resistance development and outcome among neonates between 2001 and 2008.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Secular Trends in Antibiotic Use Among Neonates

Zingg¹,

Pfister²,

Posfay‐Barbe³

et al. 2011

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Antibiotic Usementioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Secular Trends in Antibiotic Use Among Neonates

Zingg¹,

Pfister²,

Posfay‐Barbe³

et al. 2011

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

show abstract

“…19 A similar result was found recently in a study of hospitalized pediatric patients in which linezolid and macrolide use significantly increased over time; there were no reductions in other antibiotic use from 2002 to 2007. 18 In our experience, implementation of a comprehensive ASP led to significant reductions of both targeted and nontargeted antimicrobials and modifications of the patterns of antimicrobial use after ASP implementation. Total antimicrobial use decreased by 38% despite a 7% increase in the acuity of patient care from 2004 to 2007.…”

Section: Discussionmentioning

confidence: 88%

“…[11][12][13][14][15][16][17] Furthermore, beyond reporting proportions of hospitalized children who have received antimicrobials during their hospitalization, complete data about the extent of antimicrobial use in pediatric hospitals before and after ASP implementation do not currently exist. 18 Since introducing an ASP in 2004, we have prospectively evaluated its effect on antimicrobial use, physician interventions, patient outcomes, and rates of antimicrobial resistance. To the best of our knowledge, this is the first publication to thoroughly describe the impact of an ASP in a children's hospital.…”

mentioning

confidence: 99%

Benefits of a Pediatric Antimicrobial Stewardship Program at a Children's Hospital

2011

View full text Add to dashboard Cite

show abstract

Estimating National Trends in Inpatient Antibiotic Use Among US Hospitals From 2006 to 2012

et al. 2016

View full text Add to dashboard Cite

The rising threat of antibiotic resistance and other adverse consequences resulting from the misuse of antibiotics requires a better understanding of antibiotic use in hospitals in the United States. OBJECTIVE To use proprietary administrative data to estimate patterns of US inpatient antibiotic use in recent years. DESIGN, SETTING, AND PARTICIPANTS For this retrospective analysis, adult and pediatric in-patient antibiotic use data was obtained from the Truven Health MarketScan Hospital Drug Database (HDD) from January 1, 2006, to December 31, 2012. Data from adult and pediatric patients admitted to 1 of approximately 300 participating acute care hospitals provided antibiotic use data for over 34 million discharges representing 166 million patient-days. MAIN OUTCOMES AND MEASURESWe retrospectively estimated the days of therapy (DOT) per 1000 patient-days and the proportion of hospital discharges in which a patient received at least 1 dose of an antibiotic during the hospital stay. We calculated measures of antibiotic usage stratified by antibiotic class, year, and other patient and facility characteristics. We used data submitted to the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System to generate estimated weights to apply to the HDD data to create national estimates of antibiotic usage. A multivariate general estimating equation model to account for interhospital covariance was used to assess potential trends in antibiotic DOT over time.RESULTS During the years 2006 to 2012, 300 to 383 hospitals per year contributed antibiotic data to the HDD. Across all years, 55.1% of patients received at least 1 dose of antibiotics during their hospital visit. The overall national DOT was 755 per 1000 patient-days. Overall antibiotic use did not change significantly over time. The multivariable trend analysis of data from participating hospitals did not show a statistically significant change in overall use (total DOT increase, 5.6; 95% CI, −18.9 to 30.1; P = .65). However, the mean change (95% CI) for the following antibiotic classes increased significantly: third-and fourth-generation cephalosporins, 10.3 (3.1-17.5); macrolides, 4.8 (2.0-7.6); glycopeptides, 22.4 (17.5-27.3); β-lactam/β-lactamase inhibitor combinations, 18.0 (13.3-22.6); carbapenems, 7.4 (4.6-10.2); and tetracyclines, 3.3 (2.0-4.7). CONCLUSIONS AND RELEVANCEOverall DOT of all antibiotics among hospitalized patients in US hospitals has not changed significantly in recent years. Use of some antibiotics, especially broad spectrum agents, however, has increased significantly. This trend is worrisome in light of the rising challenge of antibiotic resistance. Our findings can help inform national efforts to improve antibiotic use by suggesting key targets for improvement interventions.

show abstract

Trends in Antibacterial Use in Hospitalized Pediatric Patients in United States Academic Health Centers

Cited by 48 publications

References 9 publications

Secular Trends in Antibiotic Use Among Neonates

Secular Trends in Antibiotic Use Among Neonates

Benefits of a Pediatric Antimicrobial Stewardship Program at a Children's Hospital

Estimating National Trends in Inpatient Antibiotic Use Among US Hospitals From 2006 to 2012

Contact Info

Product

Resources

About