Trends of Inpatient Antibiotic Consumption in a Children’s Clinic

Abstract

Introduction: Antimicrobials are the most commonly used medications among inpatient children. Moreover, a direct correlation exists between the magnitude of antibiotic consumption and the prevalence of resistant organisms. Surveying the trends of antibiotic consumption is crucial for establishing initiatives that are aimed at combating antibiotic-resistant infections by enhancing the rational use of antimicrobials. The objective of this study is to assess the trends of antibiotic consumption among hospitalized children for contributing toward future studies and establishing promising awareness-raising policies for appropriate antimicrobial use. Materials and Methods: The study was conducted retrospectively in a tertiary research hospital’s pediatric ward of 50 beds. Using the hospital pharmacy and administrative databases between January 1, 2014, and December 31, 2019, all hospitalized children who received antimicrobials in that period were included. Data regarding antimicrobial use were evaluated according to anatomical therapeutic chemical/defined daily doses (ATC/DDD) index methodology, described in “World Health Organisation Guidelines for ATC classification and DDD assignment 2020.” Data of antibiotic consumptions were revealed with a unit as DDD/1,000 patient-days (PD). The time trends of antibiotic consumption were statistically analyzed by linear regression. Results: Data of 11,519 pediatric inpatients were recorded, in which 6,103 (53.0%) were boys and 5,416 patients (47.0%) were girls. The median age of the patients was two years. Ceftriaxone was the most commonly used antibiotic throughout the study period. Ceftriaxone utilization has increased by 19.5% between 2014 and 2019. Despite being the most commonly used carbapenem in the study, meropenem consumption decreased significantly from 2014 to 2019 (ATC/DDD index in 2014=46.22/1,000 PD; in 2019=11.62/1,000 PD) (p=0.008). Amikacin consumption was greater than gentamicin use by 2017, but vice versa from 2017 onward. The total antibiotic consumption peaked by 2016 (856.35/1,000 PD), amid a slight drop from 2014 to 2019 (p=0.667). Conclusion: Assessing regional antimicrobial consumptions periodically is critical for establishing current antibiotic stewardship initiatives that enable the rational use of antibiotics for combating bacterial resistance.

Keywords

• antimicrobial consumption
• antibiotic consumption
• inpatient children
• hospitalized children