نبذة مختصرة : Antibiotics are among the most frequently prescribed drugs in children's hospitals, which is why regular monitoring of antibiotic use in hospitals is of great importance. This retrospective audit (60 months, January 2014 - December 2018) analyzes the antibiotic consumption at a university inpatient department of general pediatrics including neonatal and pediatric intensive care based on pharmacy dispensing data in units of grams per 100 patient days and in Defined Daily Doses per 100 patient days.The results provide potential targets for Antibiotic Stewardship interventions. Conversely, this audit elicits methodological limitations of the method of antibiotic surveillance in pediatrics recommended by the Robert Koch Institute, Berlin.
Relation: Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen (Infektionsschutzgesetz - IfSG) - Infektionsschutzgesetz vom 20. Juli 2000 (BGBl. I S. 1045), das zuletzt durch Artikel 5 des Gesetzes vom 19. Juni 2020 (BGBl. I S. 1385) geändert worden ist. 2020.; Ayalew K, Nambiar S, Yasinskaya Y, Jantausch BA. Carbapenems in pediatrics. Ther Drug Monit. 2003 Oct;25(5):593-9. DOI:10.1097/00007691-200310000-00009; Buccellato E, Melis M, Biagi C, Donati M, Motola D, Vaccheri A. Use of Antibiotics in Pediatrics: 8-Years Survey in Italian Hospitals. PLoS One. 2015 Sep;10(9):e0139097. DOI:10.1371/journal.pone.0139097; Clavenna A, Bonati M. Adverse drug reactions in childhood: a review of prospective studies and safety alerts. Arch Dis Child. 2009 Sep;94(9):724-8. DOI:10.1136/adc.2008.154377; Dancer SJ, Kirkpatrick P, Corcoran DS, Christison F, Farmer D, Robertson C. Approaching zero: temporal effects of a restrictive antibiotic policy on hospital-acquired Clostridium difficile, extended-spectrum beta-lactamase-producing coliforms and meticillin-resistant Staphylococcus aureus. Int J Antimicrob Agents. 2013 Feb;41(2):137-42. DOI:10.1016/j.ijantimicag.2012.10.013; Deutsche Gesellschaft für Pädiatrische Infektiologie. Stellungnahme der Deutschen Gesellschaft für Pädiatrische Infektiologie und des Paed IC Projektes zur Erfassung des Antibiotika-Verbrauches in Kinderkliniken im Rahmen eines Antibiotic Stewardship Programmes. 2013 Dec 02. Available from: https://dgpi.de/wp-content/uploads/2013/12/Antibiotikaverbrauch_IC-Projekt_Stellungnahme_3Dez2013.pdf; Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI). S2k Leitlinie "Antibiotic Stewardship - Konzeption und Umsetzung in der stationären Kinder- und Jugendmedizin". Version 1.12.2018. Registernummer 048/15. Berlin: AWMF; 2018.; Deutsche Gesellschaft für Pädiatrische Infektiologie e.V. (DGPI), Berner R, Bialek R, Forster J, Härtel C, Heininger U, Huppertz HI, Liese J G, Nadal D, Simon A, editors. DGPI Handbuch-Infektionen bei Kindern und Jugendlichen. 7., vollst. überarb. Aufl. Stuttgart, New York: Georg Thieme Verlag; 2018.; Drew RJ, Turton JF, Hill RL, Livermore DM, Woodford N, Paulus S, Cunliffe NA. Emergence of carbapenem-resistant Enterobacteriaceae in a UK paediatric hospital. J Hosp Infect. 2013 Aug;84(4):300-4. DOI:10.1016/j.jhin.2013.05.003; de With K, Bestehorn H, Steib-Bauert M, Kern WV. Comparison of defined versus recommended versus prescribed daily doses for measuring hospital antibiotic consumption. Infection. 2009 Aug;37(4):349-52. DOI:10.1007/s15010-008-8138-4; Feazel LM, Malhotra A, Perencevich EN, Kaboli P, Diekema DJ, Schweizer ML. Effect of antibiotic stewardship programmes on Clostridium difficile incidence: a systematic review and meta-analysis. J Antimicrob Chemother. 2014 Jul;69(7):1748-54. DOI:10.1093/jac/dku046; Gerber JS, Kronman MP, Ross RK, Hersh AL, Newland JG, Metjian TA, Zaoutis TE. Identifying targets for antimicrobial stewardship in children's hospitals. Infect Control Hosp Epidemiol. 2013 Dec;34(12):1252-8. DOI:10.1086/673982; Gerber JS, Newland JG, Coffin SE, Hall M, Thurm C, Prasad PA, Feudtner C, Zaoutis TE. Variability in antibiotic use at children's hospitals. Pediatrics. 2010 Dec;126(6):1067-73. DOI:10.1542/peds.2010-1275; Gharbi M, Doerholt K, Vergnano S, Bielicki JA, Paulus S, Menson E, Riordan A, Lyall H, Patel SV, Bernatoniene J, Versporten A, Heginbothom M, Goossens H, Sharland M; ARPEC project group members. Using a simple point-prevalence survey to define appropriate antibiotic prescribing in hospitalised children across the UK. BMJ Open. 2016 Nov;6(11):e012675. DOI:10.1136/bmjopen-2016-012675; GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WIdO). Anatomisch-therapeutisch-chemische Klassifikation mit Tagesdosen - Amtliche Fassung des ATC-Index mit DDD-Angaben für Deutschland im Jahre 2019. Berlin, Köln; 2019.; Gravatt LA, Pakyz AL. Challenges in measuring antibiotic consumption. Curr Infect Dis Rep. 2013 Dec;15(6):559-63. DOI:10.1007/s11908-013-0374-9; Hufnagel M, Versporten A, Bielicki J, Drapier N, Sharland M, Goossens H; ARPEC Project Group. High Rates of Prescribing Antimicrobials for Prophylaxis in Children and Neonates: Results From the Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey. J Pediatric Infect Dis Soc. 2019 May;8(2):143-151. DOI:10.1093/jpids/piy019; Janowski AB, Michaels MG, Martin JM, Green MD. Piperacillin-Tazobactam Usage at a Tertiary Pediatric Hospital: An Antimicrobial Stewardship Review. J Pediatric Infect Dis Soc. 2016 Sep;5(3):342-5. DOI:10.1093/jpids/piv036; Kreitmeyr K, von Both U, Pecar A, Borde JP, Mikolajczyk R, Huebner J. Pediatric antibiotic stewardship: successful interventions to reduce broad-spectrum antibiotic use on general pediatric wards. Infection. 2017 Aug;45(4):493-504. DOI:10.1007/s15010-017-1009-0; Lee KR, Bagga B, Arnold SR. Reduction of Broad-Spectrum Antimicrobial Use in a Tertiary Children's Hospital Post Antimicrobial Stewardship Program Guideline Implementation. Pediatr Crit Care Med. 2016 Mar;17(3):187-93. DOI:10.1097/PCC.0000000000000615; Levy ER, Swami S, Dubois SG, Wendt R, Banerjee R. Rates and appropriateness of antimicrobial prescribing at an academic children's hospital, 2007-2010. Infect Control Hosp Epidemiol. 2012 Apr;33(4):346-53. DOI:10.1086/664761; Lukac PJ, Bonomo RA, Logan LK. Extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: old foe, emerging threat. Clin Infect Dis. 2015 May;60(9):1389-97. DOI:10.1093/cid/civ020; Medernach RL, Logan LK. The Growing Threat of Antibiotic Resistance in Children. Infect Dis Clin North Am. 2018 Mar;32(1):1-17. DOI:10.1016/j.idc.2017.11.001; Quaak CH, Cové E, Driessen GJ, Tramper-Stranders GA. Trends in paediatric inpatient antibiotic therapy in a secondary care setting. Eur J Pediatr. 2018 Aug;177(8):1271-8. DOI:10.1007/s00431-018-3185-z; Robert Koch-Institut Berlin. Bekanntmachung des Robert Koch-Instituts: Festlegung der Daten zu Art und Umfang des Antibiotika-Verbrauchs in Krankenhäusern nach 23 Abs. 4 Satz 2 IfSG [Definition of data on the nature and extent of antibiotic consumption in hospitals by 23 paragraph 4 sentence 2 IfSG]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Jul;56(7):996-1002. DOI:10.1007/s00103-013-1780-8; Schweickert B, Eckmanns T, Bärwolff S, Wischnewski N, Meyer E. Surveillance des Antibiotikaverbrauchs in Krankenhäusern: Aufgaben des öffentlichen Gesundheitsdienstes [Surveillance of antibiotic consumption in hospitals: tasks of the Public Health Service]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Apr;57(4):399-405. DOI:10.1007/s00103-014-1942-3; Schweickert B, Kern WV, de With K, Meyer E, Berner R, Kresken M, Fellhauer M, Abele-Horn M, Eckmanns T. Antibiotika-Verbrauchs-Surveillance: Ausführungen und Erläuterungen zur Bekanntmachung "Festlegung der Daten zu Art und Umfang des Antibiotika-Verbrauchs in Krankenhäusern nach § 23 Abs. 4 Satz 2 IfSG" [Surveillance of antibiotic consumption: clarification of the "definition of data on the nature and extent of antibiotic consumption in hospitals according to § 23 paragraph 4 sentence 2 of the IfSG"]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Jul;56(7):903-12. DOI:10.1007/s00103-013-1764-8; Valcourt K, Norozian F, Lee H, Raszynski A, Torbati D, Totapally BR. Drug use density in critically ill children and newborns: analysis of various methodologies. Pediatr Crit Care Med. 2009 Jul;10(4):495-9. DOI:10.1097/PCC.0b013e3181a3101e; Weichert S, Simon A, von Müller L, Adam R, Schroten H. Clostridium-difficile-assoziierte Infektionen im Kindes- und Jugendalter. Monatsschrift Kinderheilkunde. 2015;163(5):427-36.; WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignement, 2019. Oslo; 2018.; WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2020 [updated 2019 Dec 16]. Available from: https://www.whocc.no/atc_ddd_index/; Wilcox MH, Chalmers JD, Nord CE, Freeman J, Bouza E. Role of cephalosporins in the era of Clostridium difficile infection. J Antimicrob Chemother. 2017 Jan;72(1):1-18. DOI:10.1093/jac/dkw385; Wolf MF, Simon A. The use of piperacillin-tazobactam in neonatal and paediatric patients. Expert Opin Drug Metab Toxicol. 2009 Jan;5(1):57-69. DOI:10.1517/17425250802614688; Zweigner J, Simon A. Multiresistente gramnegative Erreger in der Pädiatrie. Pädiatrie up2date. 2017;12(2):123-37. DOI:10.1055/s-0043-101269; http://dx.doi.org/10.3205/id000075; http://nbn-resolving.de/urn:nbn:de:0183-id0000757; http://www.egms.de/en/journals/id/2021-9/id000075.shtml
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