Antibiotic Consumption in Hospitalized Children at the University Clinic for Pediatric Diseases – Skopje
DOI:
https://doi.org/10.3889/oamjms.2020.4059Keywords:
antimicrobial residence, antibacterial drugs, adherence to guidelinesAbstract
BACKGROUND: The misuse and overuse of antibiotics contribute to the development of antimicrobial residence. Official data in EU/ EEA in 2017 in the hospital sector suggested that the consumption is lowest in the Netherlands, with 1 DDD per 1,000 inhabitants/day in comparison with Finland, with 2.8 DDD/TID.
AIM: The aim of this study was to analyze data on the scope and structure of the antibiotic prescription in pediatric patients at University Children’s Hospital for period of 3 months in 2018 and 2019.
MATERIALS AND METHODS: The data for antibiotic consumption were obtained from a hospital pharmacy, which are ordinated to hospitalized patients.
RESULTS: The total amount of utilized antibacterial drugs with ATC code J01 for first quarter in 2018 is 33.65 DDD/100BD in comparison to the first quarter of 2019 when it declined to 32.09 DDD/100BD. The most consummated antibiotics in the first trimester of both years were the group of cephalosporins, especially the 3rd- and 4th-generation parenteral cephalosporins with from 16.96 to 19.25 DDD/100BD in the evaluated period. Decrease of penicillin’s, carbapenems, macrolides and quinolones were confirmed in the analyzed period. The most commonly used drugs remain ceftriaxone – 13.49 DDD/100BD in 2018 and increased to 14.41 DDD/100BD in 2019, followed by amikacin 3.21 DDD/100BD in 2018 and increased to 3.50 DDD/100BD in 2019 but azithromycin consumption significantly declined from 1.97 DDD/100BD to 0.81 DDD/100BD administered orally. The third most commonly utilized antibiotic in first quarter of 2019 become meropenem, antimicrobial drug from the group of carbapenems with 2.71 DDD/100BD.
CONCLUSION: The benefits of monitoring the antibiotic prescribed pattern are critical due to the fact that they provide adequate data on consumption of antibiotics and adherence to guidelines.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
EASAC (Council). Tackling Antibacterial Resistance in Europe. Available from: https://www.easac.eu/fileadmin/PDF_s/reports_ statements/Tackling.pdf. [Last accessed on 2019 November 10].
European Centre for Disease Prevention and Control. Antimicrobial Consumption. In: Annual Epidemiological Report for 2017 Antimicrobial Consumption. Sweden: European Centre for Disease Prevention and Control;
Available from: https://www.ecdc.europa.eu/sites/portal/files/ documents/AER_for_2017-antimicrobial-consumption.pdf. [Last accessed on 2019 November 10].
Republic of North Macedonia. National Strategy for Antimicrobial Resistance AMR in the Republic of North Macedonia 2019- 2023. Republic of North Macedonia; 2019.
Antimicrobial Resistance. Available from: http://www.ecdc. europa.eu/en/healthtopics/antimicrobial_resistance/Pages/ index.aspx. [Last accessed on 2019 November 10].
Antimicrobial Use. Available from: http://www.who.int/ drugresistance/use/en. [Last accessed on 2019 November 10].
Central Asian and Eastern European Surveillance of Antimicrobial Resistance. Annual Report 2016. Available from: http://www.euro.who.int/_data/assets/pdf_file/0006/285405/ CAESAR-surveillance-antimicrobial-resistance2016.pdf. [Last accessed on 2019 November 10].
Chaw PS, Schlinkmann KM, Raupach-Rosin H, Karch A, Pletz MW, Huebner J, et al. Antibiotic use on paediatric inpatientsin a teaching hospital in the Gambia,a retrospective study. Antimicrob Resist Infect Control. 2018;7:82. PMid:30026940
Sharma R, Sharma CL, Kapoor B. Antibacterial resistance: Current problems and possible solutions. Indian J Med Sci. 2005;59(3):120-9. https://doi.org/10.4103/0019-5359.15091 PMid:15805685
Al-Tawfiq JA. Antibiotic resistance of pediatric isolates of Streptococcus pneumoniae in a Saudi Arabian hospital from 1999 to 2004. Med Sci Monit. 2006;12(11):CR471-5. PMid:17072272
Bartoloni A, Pallecchi L, Benedetti M, Fernandez C, Vallejos Y, Guzman E, et al. Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia. Emerg Infect Dis. 2006;12(6):907- 13. https://doi.org/10.3201/eid1206.051258
Fritzsche M, Ammann RA, Droz S, Bianchetti MG, Aebi C. Changes in antimicrobial resistance of Escherichia coli causing urinary tract infections in hospitalized children. Eur J Clin Microbiol Infect Dis. 2005;24(3):233-5. https://doi.org/10.1007/ s10096-005-1301-2 PMid:15772820
Al-Tawfiq JA, Anani AA. Antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infections in a Saudi Arabian hospital. Chemotherapy. 2009;55(2):127-31. https://doi. org/10.1159/000198698 PMid:19188712
von Gunten V, Troillet N, Beney J, Boubaker K, Lüthi JC, Taffé P, et al. Impact of an interdisciplinary strategy on antibiotic use: A prospective controlled study in three hospitals. J Antimicrob Chemother. 2005;55(3):362-6. https:// doi.org/10.1093/jac/dki021 PMid:15705638
Polk RE, Fox C, Mahoney A, Letcavage J, MacDougall C. Measurement of adult antibacterial drug use in 130 US hospitals: Comparison of defined daily dose and days of therapy. Clin Infect Dis. 2007;44(5):664-70. https://doi.org/10.1086/511640 PMid:17278056
World Health Organization. Collaborating Centre for Drug Statistics Methodology, Guidelines for ATC classification and DDD Assignment 2018. Oslo, Norway: World Health Organization; 2017.
Rogues AM, Dumartin C, Amadéo B, Venier AG, Marty N, Parneix P, et al. Relationship between rates of antimicrobial consumption and the incidence of antimicrobial resistance in Staphylococcus aureus and Pseudomonas aeruginosa isolates from 47 French hospitals. Infect Control Hosp Epidemiol. 2007;28(12):1389-95. https://doi.org/10.1086/523280 PMid:17994520
Plüss-Suard C, Pannatier A, Kronenberg A, Mühlemann K, Zanetti G. Impact of antibiotic use on carbapenem resistance in Pseudomonas aeruginosa: Is there a role for antibiotic diversity? Antimicrob Agents Chemother. 2013;57:1709-13. https://doi. org/10.1128/aac.01348-12 PMid:23357763
Gbaguidi-Haore H, Dumartin C, L’Hériteau F, Péfau M, Hocquet D, Rogues AM, et al. Antibiotics involved in the occurrence of antibiotic-resistant bacteria: A nationwide multilevel study suggests differences within antibiotic classes. J Antimicrob Chemother. 2013;68(2):461-70. https:// doi.org/10.1093/jac/dks406 PMid:23075690
Available from: http://www.whocc.no/filearchive/ publications/1_2013guidelines.pdf. [Last accessed on 2019 November 10].
Jakovljevic E, Ilić K, Jelesić Z, Konstantinidis G. A one-year prospective study on the antibiotic resistance of E-coli strains isolated in urinary specimens of children hospitalized at the University Pediatric Medical Center in Novi Sad, Serbia. Infection. 2013;41(6):1111-9. https://doi.org/10.1007/s15010-013-0493-0
ISKRA, Antimicrobial Resistance Surveillance in Human Medicine CROATIA, Pracenje Otpornosti Bakterija na Antibiotike HRVATSKA. Available from: http://www.iskra.bfm.hr/hrv/Default. aspx. [Last accessed on 2019 November 10].
Review of Antibiotics Expenditure in the Canton Sarajevo in Period 2016/2017. Available from: https://www.mz.ks.gov. ba/sites/mz.ks.gov.ba/files/izvjestaj_o_potrosnji_antibiotika_ za_2016_2017_parafirano.pdf. [Last accessed on 2019 November 10].
Gould IM, Lawes T. Antibiotic stewardship: Prescribing social norms. Lancet. 2016;387(10029):1699-701. https://doi. org/10.1016/s0140-6736(16)00007-6 PMid:26898851
Buising KL, Thursky KA, Robertson MB, Black JF, Street AC, Richards MJ, et al. Electronic antibiotic stewardship reduced consumption of broad-spectrum antibiotics using a computerized antimicrobial approval system in a hospital setting. J Antimicrob Chemother. 2008;62(3):608-16. https://doi.org/10.1093/jac/ dkn218 PMid:18550680
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2020 Iskra Pechijareva-Sadikarijo, Zorica Naumovska, Ognen Petrovski, Katerina Stavrikj, Trajan Balkanov (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0