Use of antibiotics in pediatric intensive care and potential savings.

Details

Serval ID
serval:BIB_24C711ECDFFF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of antibiotics in pediatric intensive care and potential savings.
Journal
Intensive care medicine
Author(s)
Fischer J.E., Ramser M., Fanconi S.
ISSN
0342-4642
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
26
Number
7
Pages
959-66
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
OBJECTIVE: Minimizing unwarranted prescription of antibiotics remains an important objective. Because of the heterogeneity between units regarding patient mix and other characteristics, site-specific targets for reduction must be identified. Here we present a model to address the issue by means of an observational cohort study. SETTING: A tertiary, multidisciplinary, neonatal, and pediatric intensive care unit of a university teaching hospital. PATIENTS: All newborns and children present in the unit (n = 456) between September 1998 and March 1999. Reasons for admission included postoperative care after cardiac surgery, major neonatal or pediatric surgery, severe trauma, and medical conditions requiring critical care. METHODS: Daily recording of antibiotics given and of indications for initiation. After discontinuation, each treatment episode was assessed as to the presence or absence of infection. RESULTS: Of the 456 patients 258 (56.6%) received systemic antibiotics, amounting to 1815 exposure days (54.6%) during 3322 hospitalization days. Of these, 512 (28%) were prescribed as prophylaxis and 1303 for suspected infection. Treatment for suspected ventilator-associated pneumonia accounted for 616 (47%) of 1303 treatment days and suspected sepsis for 255 days (20%). Patients were classified as having no infection or viral infection during 552 (40%) treatment days. The average weekly exposure rate in the unit varied considerably during the 29-week study period (range: 40-77/100 hospitalization days). Patient characteristics did not explain this variation. CONCLUSION: In this unit the largest reduction in antibiotic treatment would result from measures assisting suspected ventilator-associated pneumonia to be ruled out and from curtailing extended prophylaxis.
Keywords
Anti-Bacterial Agents, Antibiotic Prophylaxis, Child, Preschool, Cohort Studies, Drug Resistance, Microbial, Drug Utilization Review, Female, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Length of Stay, Male, Multivariate Analysis, Practice Guidelines as Topic, Regression Analysis, Switzerland
Pubmed
Web of science
Create date
25/01/2008 10:06
Last modification date
20/08/2019 13:03
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