Antimicrobial Use Over a Four‐Year Period Using Days of Therapy Measurement at a Canadian Pediatric Acute Care Hospital

Dalton, Bruce; MacTavish, Sandra J; Bresee, Lauren; Rajapakse, Nipunie; Vanderkooi, Otto G; Vayalumkal, Joseph; Conly, John

doi:10.1155/2015/835209

Cited by 18 publications

(18 citation statements)

References 12 publications

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“…Furthermore, most DOTs data were not ICU-specific nor differentiating between different types of pediatric ICUs [23–25]. Nevertheless, using DOTs per 1000 patient-days, the overall antimicrobial consumption in pediatric ICUs in the current study (697.0) was generally comparable to those reported in USA and Canada (approximately 750) [25, 26]. In contrast, the overall antimicrobial consumption in neonatal ICU in the current study (324.5) was slightly higher than reported in USA (approximately 250) [9, 27] but much lower than reported in Russia (> 1000) [28].…”

Section: Discussionmentioning

confidence: 50%

Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study

Balkhy

El-Saed

Alshehri³

et al. 2019

Ann Clin Microbiol Antimicrob

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Background Despite their critical role in antimicrobial stewardship programs, data on antimicrobial consumption among the pediatric and neonatal population is limited internationally and lacking in Saudi Arabia. The current study was done as part of our antimicrobial stewardship activities. Objectives To calculate overall and type-specific antimicrobial consumption. Methods A prospective surveillance study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between October 2012 and June 2015 in two pediatric and one neonatal intensive care units (ICUs). Consumption data were collected manually on a daily basis by infection control practitioners. Data were presented as days of therapy (DOT) per 1000 patient-days and as frequency of daily consumption. Results During the 33 months of the study, a total of 30,110 DOTs were monitored during 4921 admissions contributing 62,606 patient-days. Cephalosporins represented 38.0% of monitored antimicrobials in pediatric ICUs followed by vancomycin (21.9%), carbapenems (14.0%), aminoglycosides (8.8%), and piperacillin/tazobactam (8.8%). Their consumption rates were 265.1, 152.6, 97.6, 61.4, and 61.4 DOTs per 1000 patient-days (respectively). Aminoglycosides represented 45.4% of monitored antimicrobials in neonatal ICU followed by cephalosporins (30.4%) vancomycin (13.6%), and carbapenems (8.3%). Their consumption rates were 147.5, 98.7, 44.3, and 27 DOTs per 1000 patient-days (respectively). Conclusion Cephalosporins are frequently used in pediatric ICU while aminoglycosides are frequently used in neonatal ICU. The local consumption of cephalosporins and carbapenems in both ICUs is probably higher than international levels. Such data can help in establishing and monitoring the functions of antimicrobial stewardship activities aiming to ensure judicious consumption of antimicrobials.

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Section: Discussionmentioning

confidence: 50%

Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study

Balkhy

El-Saed

Alshehri³

et al. 2019

Ann Clin Microbiol Antimicrob

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“…As most of the DOT-based international reports of antimicrobial consumption were derived from whole hospital data [21, 36] or pediatric/neonatal populations [37, 38], comparing the current ICU-specific DOT rates is challenging. Nevertheless, this study had slightly higher carbapenems (235.7 versus 196.3) but lower piperacillin/tazobactam (145.9 versus 296.3) and vancomycin (129.5 versus 187.2) compared with a study done in an adult ICU in Canada [39].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study

Balkhy

El-Saed

El-Metwally

et al. 2018

Antimicrob Resist Infect Control

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BackgroundEstimating the baseline antimicrobial consumption is extremely important to monitor the impact of antimicrobial stewardship activities that aim to reduce the burden and cost of antimicrobial consumption.ObjectivesTo quantify service-specific antimicrobial consumption using different metrics.MethodsA surveillance study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between October 2012 and June 2015 in five adult intensive care units (ICUs). Consumption data were collected manually on a daily basis by infection control practitioners. Data were presented as defined daily dose (DDD), days of therapy (DOT) per 1000 patient days, and frequency of daily consumption.ResultsA total of 43,970 DDDs and 46,940 DOTs were monitored during 54,116 patient-days. For the most frequently consumed antimicrobials, the consumption of carbapenems, piperacillin/tazobactam, vancomycin, and colistin (respectively) in all ICUs combined were 255.9, 134.3, 98.2, and 13.6 DDDs per 1000 patient-days and 235.7, 145.9, 129.5, and 117.5 DOTs per 1000 patient-days. For the frequency of daily consumption, carbapenems were the most frequently consumed antimicrobial group in medical/surgical, burn, and step-down ICUs while piperacillin/tazobactam was the most frequently consumed antimicrobial in neuro-surgical and cardio-thoracic ICUs.ConclusionHigh consumption of broad-spectrum antimicrobial agents such as meropenem and piperacillin/tazobactam is observed in multiple ICUs in a tertiary care hospital. Meropenem consumption is considerably higher than similar ICUs internationally. Future studies focusing on concurrent monitoring of antimicrobial resistance and identifying patient and physician characteristics associated with specific prescription patterns may help in improving judicious antimicrobial consumption.

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“…This difference may be attributable to seasonal variation because prescription rates increased during winter months in our study period [31]. The current antibiotic consumption places in our center are at the higher end of the ranges reported in Switzerland, Canada and the USA, where 550, 750 and 1000 DOTs per 1000 patient-days, respectively, have been reported [2,4,32].…”

Section: Discussionmentioning

confidence: 69%

Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: A retrospective cohort study

Kazzaz

AlTurki²,

Aleisa³

et al. 2020

Preprint

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Background: Inappropriate antibiotic utilization is associated with the emergence of antimicrobial resistance (AMR) and a decline in antibiotic susceptibility in many pathogenic organisms isolated in intensive care units. Antibiotic stewardship programs (ASPs) have been recommended as a strategy to reduce and delay the impact of AMR. A crucial step in ASPs is understanding antibiotic utilization practices and quantifying the problem of inappropriate antibiotic use to support a targeted solution. We aim to characterize antibiotic utilization and determine the appropriateness of antibiotic prescription in a tertiary care pediatric intensive care unit.Methods: A retrospective cohort study was conducted at King Abdullah Specialized Children’s Hospital (KASCH), Riyadh, Saudi Arabia, over a 6-month period. Days of therapy (DOT) and DOT per 1000 patient-days were used as measures of antibiotic consumption. The appropriateness of antibiotic use was assessed by two independent pediatric infectious disease physicians based on the Centers for Disease Control and Prevention 12-step Campaign to Prevent Antimicrobial Resistance Among Hospitalized Children.Results: During the study period, 497 patients were admitted to the PICU, accounting for 3009 patient-days. A total of 274 antibiotic courses were administered over 2553 antibiotic days. Forty-eight percent of antibiotic courses were found to be nonadherent to at least 1 CDC step. The top reasons were inappropriate antibiotic choice (empirical or definitive) and inappropriate prophylaxis durations. Cefazolin and vancomycin contributed to the highest percentage of inappropriate DOTs.Conclusions: Antibiotic consumption was high with significant inappropriate utilization. These data could inform decision-making in antimicrobial stewardship programs and strategies. The CDC steps provide a more objective tool and limit biases when assessing antibiotic appropriateness

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Antimicrobial Use Over a Four‐Year Period Using Days of Therapy Measurement at a Canadian Pediatric Acute Care Hospital

Cited by 18 publications

References 12 publications

Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study

Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study

Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study

Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: A retrospective cohort study

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