Observational Study of Antibiotic Usage at the Children's Clinical University Hospital in Riga, Latvia
Observational Study of Antibiotic Usage at the Children's Clinical University Hospital in Riga, Latvia
复制标题
DOI：
10.3390/medicina54050074
复制
发表时间：
2018-11-01
影响因子：
2.6
通讯作者：
Mozgis, Dzintars
中科院分区：
文献类型：
--
作者：
Sviestina, Inese;Mozgis, Dzintars
背景和目的：许多儿科患者在住院期间接受了抗生素治疗。有必要改善儿科患者的抗生素处方，因为这些处方中有许多是不合适的。在儿童临床大学医院进行了抗生素消耗分析，以确定质量改进的目标。材料与方法：在2011-2013年5月和11月使用先前验证和标准化的方法进行了为期一天的横断面点患病率调查（PPS）。调查包括所有住院儿科和新生儿床位，并确定了调查当天接受抗生素治疗的所有儿童。还使用限定日剂量（DDD）方法和2006-2015年期间的抗生素药物利用（90%DU）分析了属于ATC J 01类的全身性抗生素的总消耗量（安非尼考（J 01 B）和抗菌药物组合（J 01 R）除外）。使用DDD和90%DU方法将结果与2017年的结果进行比较。结果如下：除2011年5月和11月外，所有PPS中最常用的抗生素组为其他β-内酰胺类抗生素（J 01 D）：2013年5月有42例（40%）处方，2011年11月有66例（42%）处方。在2006-2015年和2017年，最常用的抗生素组是青霉素类（J 01 C）和其他β-内酰胺类抗生素（J 01 D）-占2006年登记的抗生素总消耗量的76%（90%DU），2015年为73%，2017年为70%。从2008年开始，阿莫西林是医院最常用的抗生素。头孢曲松的使用率从2006年的3%增加到2015年的13%，但在2017年下降（7%）。结论：2006-2015年的研究结果表明，有必要在医院建立更强有力的抗生素处方政策，减少广谱抗生素（特别是第三代头孢菌素）的使用，增加窄谱抗生素的使用。这在2017年部分实现，头孢曲松的使用有所减少。
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 beta-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 beta-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.