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Survey assessed worldwide hospital antimicrobial prescription rates
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WASHINGTON, D.C. — A point prevalence survey project accurately assessed worldwide antimicrobial prescribing among hospitalized children, according to data presented at ICAAC 2014.
Ann Versporten, MPH, of the University of Antwerp in Belgium, and colleagues examined data collected through the Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey (ARPEC-PPS) to assess worldwide variation in antimicrobial prescription among hospitalized children. Standardized and validated records were reviewed from hospitals in 41 countries, including Europe, Africa, Asia, Latin America, the United States and Australia. The included 12,217 children aged 1 month who received an antimicrobial during the survey.
Ann Versporten
The rate of antimicrobial prescription was 44%, but varied between wards and countries. Antimicrobial prescription ranged from 35% in pediatric cardiology wards to 77% in pediatric transplant wards; and from 26% in Lithuania to 92% in ormer Yugoslav Republic of Macedonia.
Antibiotics made up 85% of prescribed antimicrobials, antifungals and antivirals accounted for 10% and 5%, respectively. Proportional parenteral antimicrobial treatment was 67%, and indication for antimicrobial use was noted in 70%.
Seventy-one percent of 9,383 antimicrobials used in children were prescribed for treatment and 28% for prophylaxis. Seventy percent of antimicrobials prescribed for treatment were used for a community-acquired infection and 30% for a hospital-acquired infection.
Seventy percent of antimicrobials prescribed for prophylaxis were used for medical prophylaxis and 30% for surgical prophylaxis. Medical prophylaxis rates ranged from 7% in Latin America to 65% in Africa, with trimethoprim most often prescribed. Surgical prophylaxis rates varied less by region and primarily included cephalosporins, which were administered for more than day in 80% of cases.
Prescribed antibiotics were most commonly indicated for lower respiratory tract infection (23%), prophylaxis (23%) and sepsis (11%). The top three antibiotics prescribed were ceftriaxone (9%), (7%) and co-amoxiclav (7%).
“The point prevalence survey method offered a standardized tool to assess quantity and quality of antibiotic prescribing in hospitalized children worldwide,” researchers wrote. “These data can serve to identify targets for quality improvement of antimicrobial prescribing and hospital antimicrobial stewardship programs.”
For more information:
Versporten A. Abstract G-988. Presented at: 2014 Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9; Washington, D.C.
Disclosure: The researchers report no relevant financial disclosures.