Observational Study of Antibiotic Usage at the Children’s Clinical University Hospital in Riga, Latvia

Abstract

Background and objectives: Many pediatric patients have been treated with antibiotics during their hospitalization. There is a need to improve antibiotic prescribing for pediatric patients because many of these prescriptions are inappropriate. Antibiotic consumption analysis was conducted at the Children’s Clinical University Hospital to identify targets for quality improvement. Materials and Methods: A one day cross-sectional point prevalence survey (PPS) was conducted in May and November 2011–2013 using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antibiotic treatment on the day of survey. Total consumption of systemic antibiotics belonging to the ATC J01 class (except amphenicols (J01B) and a combination of antibacterials (J01R)) was also analyzed by using a defined daily dose (DDD) approach and antibiotic drug utilization (90%DU) for the period 2006–2015. Results were compared with results in 2017 using the DDD and 90%DU methodology. Results: The most commonly used antibiotic group in all PPS, except in May and November 2011, was other β-lactam antibiotics (J01D): 42 (40%) prescriptions in May 2013 and 66 (42%) and November 2011. In 2006–2015 and also in 2017, the most commonly used antibiotic groups were penicillins (J01C) and other β-lactam antibiotics (J01D)—76% (90%DU) of the total antibiotic consumption registered in 2006, 73% in 2015 and 70% in 2017. Starting in 2008, amoxicillin was the most commonly used antibiotic at the hospital. The usage of ceftriaxone increased from 3% in 2006 to 13% in 2015, but decreased in 2017 (7%). Conclusions: Study results from 2006–2015 showed that there was a need to establish a stronger antibiotic prescribing policy in the hospital reducing the use of broad-spectrum antibiotics (especially 3rd generation cephalosporins) and increasing the use of narrower spectrum antibiotics. It was partly achieved in 2017 with some reduction in ceftriaxone use.

Rational Use of Antibiotics – A Point Prevalence Study Carried out at a Tertiary Hospital in South-South Nigeria

“…The major route of administration of the antibiotics in this present study was intravenous. This is also similar to the findings of the Riga study where 76 to 86% of all prescriptions were via the intravenous route [16]. In practice, the intravenous route is usually used in the treatment of severe systemic infections in hospitalized patients.…”

“…This is similar to the reports of another study in South-east Nigeria (78.6%) [14] and Uganda (79%) [15]. The prevalence of antibiotic use in this present study is however higher than the findings of Sviestina and Mozgis [16] who observed that only between 26% to 38% of inpatients in their point prevalence study in Childrens' Clinical university hospital, Riga, Latvia (Northern Europe) were receiving antibiotics. The likely reason for the difference in the prevalence of antibiotic use may be because, in the Riga study, the hospital has an established ward-based clinical pharmacist service.…”

“…Most infections treated on an out-patient basis are mild diseases that can be managed by oral antibiotics from the penicillin group. Sviestina and Mozgis, [16] in their study in Riga also reported penicillins and other Beta-lactam antibiotics as the most commonly used antibiotics. They observed an increasing trend in the use of cephalosporins which was linked to the development of resistance [16].…”

Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

“…[14][15][16] It was more as compared to studies done in Latvia (26-38%), Brazil (24.4%) and Spain (16.5%). [17][18][19] Study done in USA was a very large study which showed percentage of antibiotic use of 38-72% in different states of USA with mean use of 60%. 20 On comparing our study with similar Indian studies (from Andhra Pradesh, Puducherry and Kolkata percentage of encounter with antibiotic was 50.05, 60 and 79.82% respectively), our antibiotic usage was quite less.…”

Policies to Reduce Antibiotic Consumption: The Impact in the Basque Country

“…The effects of this type of program have not been studied in-depth, and few comparisons can be found in literature. Studies monitoring the consumption of antibiotics predominate in different contexts, such as hospitals [ 14 , 15 ] and primary care [ 16 , 17 , 18 , 19 ]. All of them conclude with the recommendation not only to introduce health policies to reduce the consumption of these drugs but also to quantify the results.…”