Antimicrobial Resistance and Infection Control (Apr 2023)

Antimicrobial use among paediatric inpatients at hospital sites within the Canadian Nosocomial Infection Surveillance Program, 2017/2018

  • Wallis Rudnick,
  • John Conly,
  • Daniel J. G. Thirion,
  • Kelly Choi,
  • Linda Pelude,
  • Joelle Cayen,
  • John Bautista,
  • Lizanne Beique,
  • Jeannette L. Comeau,
  • Bruce Dalton,
  • Johan Delport,
  • Rita Dhami,
  • Joanne Embree,
  • Yannick Émond,
  • Gerald Evans,
  • Charles Frenette,
  • Susan Fryters,
  • Jennifer Happe,
  • Kevin Katz,
  • Pamela Kibsey,
  • Joanne M. Langley,
  • Bonita E. Lee,
  • Marie-Astrid Lefebvre,
  • Jerome A. Leis,
  • Allison McGeer,
  • Susan McKenna,
  • Heather L. Neville,
  • Kathryn Slayter,
  • Kathryn N. Suh,
  • Alena Tse-Chang,
  • Karl Weiss,
  • Michelle Science,
  • the Canadian Nosocomial Infection Surveillance Program

DOI
https://doi.org/10.1186/s13756-023-01219-x
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 9

Abstract

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Abstract Background Antimicrobial resistance threatens the ability to successfully prevent and treat infections. While hospital benchmarks regarding antimicrobial use (AMU) have been well documented among adult populations, there is less information from among paediatric inpatients. This study presents benchmark rates of antimicrobial use (AMU) for paediatric inpatients in nine Canadian acute-care hospitals. Methods Acute-care hospitals participating in the Canadian Nosocomial Infection Surveillance Program submitted annual AMU data from paediatric inpatients from 2017 and 2018. All systemic antimicrobials were included. Data were available for neonatal intensive care units (NICUs), pediatric ICUs (PICUs), and non-ICU wards. Data were analyzed using days of therapy (DOT) per 1000 patient days (DOT/1000pd). Results Nine hospitals provided paediatric AMU data. Data from seven NICU and PICU wards were included. Overall AMU was 481 (95% CI 409–554) DOT/1000pd. There was high variability in AMU between hospitals. AMU was higher on PICU wards (784 DOT/1000pd) than on non-ICU (494 DOT/1000pd) or NICU wards (333 DOT/1000pd). On non-ICU wards, the antimicrobials with the highest use were cefazolin (66 DOT/1000pd), ceftriaxone (59 DOT/1000pd) and piperacillin-tazobactam (48 DOT/1000pd). On PICU wards, the antimicrobials with the highest use were ceftriaxone (115 DOT/1000pd), piperacillin-tazobactam (115 DOT/1000pd), and cefazolin (111 DOT/1000pd). On NICU wards, the antimicrobials with the highest use were ampicillin (102 DOT/1000pd), gentamicin/tobramycin (78 DOT/1000pd), and cefotaxime (38 DOT/1000pd). Conclusions This study represents the largest collection of antimicrobial use data among hospitalized paediatric inpatients in Canada to date. In 2017/2018, overall AMU was 481 DOT/1000pd. National surveillance of AMU among paediatric inpatients is necessary for establishing benchmarks and informing antimicrobial stewardship efforts.

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