Antibacterial Agents in Pediatrics

Chávez-Bueno, Susana; Stull, Terrence L.

doi:10.1016/j.idc.2009.06.011

Cited by 25 publications

(9 citation statements)

References 77 publications

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“…The third generation cephalosporins were also active against penicillin nonsusceptible Staphylococcus pneumoniae, Haemophilus, Neisseria, Moraxella sp. A group of cephalosporins for broad spectrum can be used as empirical therapy of various types of infections and third generation cephalosporins have been in use to replace penicillin as a first line therapy [17] .…”

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confidence: 99%

Rationality of Antibiotic Usage in Pediatrics in Bengkulu, Indonesia: Gyssens? Criteria and Type of Therapy Analysis

Muslim¹,

Meinisasti²

2016

pharmaceutical-sciences

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Infectious diseases are one of the biggest health problems not only in Indonesia, but also in the whole world. Prescribing antibiotics in Indonesia are quite high and increased the incidence of resistance. This study is aimed to evaluate the rationality of antibiotic use in children at the hospital qualitatively. This research is descriptive analysis of retrospective antibiotic prescribing data in children use a Gyssens' criteria and types of antibiotic therapy. Incidence of infection in children under 12 y of age amounted to 93.2%. The analysis results by using the Gyssens' criteria are obtained category O (rational use) of 32%, V (no indication) of 27.4%, inappropriate dose (IIA) of 0.6%, inappropriate interval (IIB) of 1.7%, duration too short (IIIA) of 2.9%, duration too long (IIIB) of 11.4%, alternative more effective (IVA) of 17.7%, alternative less toxic (IVB) of 2.9%, alternative less cost (IVC) of 2.9% and alternative narrower spectrum (IVD) of 0.6%. The results showed that the grouping of most types of therapy was antimicrobial drugs empiric therapy in 47.4% cases followed successively by antimicrobial drugs unknown therapy 32.6%, antimicrobial drugs documented therapy amounted to 12%, antimicrobial drugs extended empiric therapy amounted to 6.9% and antimicrobial drugs prophylaxis therapy amounted to 1.1%. The use of antibiotics in paediatric patients at the hospital in Bengkulu, Indonesia substantially has been inappropriate based on qualitative analysis. Key words: Antibiotics, paediatric, Gyssens' criteriaInfectious diseases in Indonesia are still among the top ten most prevalent diseases. Most infections, especially in children under 5 y old (toddlers) are acute respiratory tract infections amounted to 18% [1] . The prevalence of respiratory infections and pneumonia are highest in the age group 1-4 years in the population of Indonesia. An antibiotic prescribing in Indonesia is quite high, which might contribute to increase in the incidence of resistance. The impact of antibiotic resistance is increasing the morbidity, mortality and health care costs. In the last decade, many microorganisms showed an increase in the incidence of resistance to standard therapy. It is an estimated worldwide phenomenon caused by misuse and overuse of antibiotics.A study in two major cities in Indonesia (Semarang and Surabaya) found 76% of prescribing antibiotics were intended for groups of paediatric patients. Another report from the city of Denpasar, Indonesia showed that antibiotic prescriptions for children was at a high level of 265 prescriptions (90.4%) out of a total of 293 [2] . In the United States, each year a large number of antibiotic prescriptions are for children and out of those in 50% of the cases, prescribing an antibiotic was not indicated [3] . In Canada, 74% of preschool children were prescribed antibiotics for the treatment of respiratory infections and 85% of these cases got a prescription for an antibiotic, when not needed [4] . Most at risk were young children, teenagers, and those with medical ...

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Rationality of Antibiotic Usage in Pediatrics in Bengkulu, Indonesia: Gyssens? Criteria and Type of Therapy Analysis

Muslim¹,

Meinisasti²

2016

pharmaceutical-sciences

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“…Antibiotic resistance of bacteria causing paediatric infections has reportedly increased dramatically in recent years [9]. Whereas the problem of antibiotic resistance used to be confined to hospital settings, it has become common also in community settings [16].…”

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Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group

et al. 2014

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“…Hence, the use of these drugs may not be rational but may be considered as "off-label" use. [12][13][14][15][16] The criteria for initial AMA selection was mainly empirical (n = 81.2%) based on the site and severity of infection, and likely pathogens in most of the neonates and in only 18.7% subjects, it was definitive, based on previous laboratory report. Other studies have also reported a similar pattern of empirical use of AMAs.…”

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confidence: 99%

A prospective study of the pattern of antimicrobial use in neonatal intensive care unit of a tertiary care hospital

Anitha¹,

Pundarikaksha²

2017

Natl J Physiol Pharm Pharmacol

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Background: Neonatal intensive care management (NICM) involves the use of a multiplicity of medications of different categories. Antimicrobial agents (AMAs) are the most frequently prescribed during NICM, either for prophylaxis or treatment of infections. Aims and Objectives: The objective of this study was to study the pattern of antimicrobial AMA use and criteria for their selection. Materials and Methods: Case records of 150 neonates admitted to NICU and received AMAs were analyzed prospectively for the pattern of AMA use, criteria for selection, dose, route, frequency, duration of administration, AMA combinations, and any change in AMA therapy. Results: A total of 93 male and 57 female neonates with a mean age of 3.44 days were admitted for prematurity and respiratory distress. The mean duration of hospitalization was 10.67 ± 6.29 days, and the total number of AMAs used was 20, with a mean of 2.56 per neonate. The most commonly used AMAs were aminoglycosides and beta-lactams. AMAs were used in combination in most cases (98.7%) and were rational, except ampicillin + cloxacillin. All AMAs were used by IV route, supplemented by oral/topical in 2 cases; the mean duration of administration was 6.02 days. The initial choice of AMAs was mainly empirical. Change of AMAs was required in 60.6% of cases based on clinical response/laboratory data. Conclusions: The use of AMAs in NICU was mainly empirical, and definitive therapy was based on laboratory data. AMA combinations were used in most cases, and change in therapy was based on clinical response/laboratory data.

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Antibacterial Agents in Pediatrics

Cited by 25 publications

References 77 publications

Rationality of Antibiotic Usage in Pediatrics in Bengkulu, Indonesia: Gyssens? Criteria and Type of Therapy Analysis

Rationality of Antibiotic Usage in Pediatrics in Bengkulu, Indonesia: Gyssens? Criteria and Type of Therapy Analysis

Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group

A prospective study of the pattern of antimicrobial use in neonatal intensive care unit of a tertiary care hospital

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