Development of Antimicrobial Defined Daily Dose (DDD) for the Pediatric Population
Elena Montecatine-Alonso,
Marta Mejías-Trueba,
Walter Alfredo Goycochea-Valdivia,
Estibaliz Chavarri-Gil,
Cecilia M. Fernández-Llamazares,
Elisenda Dolz,
José María Gutiérrez-Urbón,
Carmen Gallego-Fernández,
Jesús Llorente-Gutiérrez,
María Victoria Gil-Navarro
Affiliations
Elena Montecatine-Alonso
Department of Pharmacy, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
Marta Mejías-Trueba
Department of Pharmacy, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
Walter Alfredo Goycochea-Valdivia
Paediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío, Institute of Biomedicine of Seville (IBIS), 41013 Sevilla, Spain
Estibaliz Chavarri-Gil
Department of Pharmacy, Hospital Universitario de Cruces, 48903 Barakaldo, Spain
Cecilia M. Fernández-Llamazares
Department of Pharmacy, Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Research Network on Maternal and Child Health and Development II (Red SAMID II). Spanish Health Institute Carlos III, 28007 Madrid, Spain
Elisenda Dolz
Department of Pharmacy, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Las Palmas de Gran Canarias, Spain
José María Gutiérrez-Urbón
Department of Pharmacy, Complexo Hospitalario Universitario A Coruña, 15006 A Coruña, Spain
Carmen Gallego-Fernández
Department of Pharmacy, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
Jesús Llorente-Gutiérrez
Department of Pharmacy, Hospital Universitario Infanta Sofía, 28703 San Sebastián de los Reyes, Spain
María Victoria Gil-Navarro
Department of Pharmacy, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improve patient outcomes, and reduce resistance. To assess the effectiveness of ASPs, it is necessary to have indicators that can be widely used. Defined daily dose (DDD) was designed by WHO for the adult population as a consumption indicator. However, there are no DDDs adapted to the pediatric population. The main objective of this study is to establish the most appropriate DDD values in this population. An observational, retrospective, multicenter study was conducted. Antimicrobial prescriptions were collected from pediatric wards of seven Spanish tertiary hospitals for 2 years. The DDDs obtained from the prescriptions were compared with the theoretical DDDs agreed upon in the first stage. To select the optimal DDD, the following were analyzed: power value, magnitude obtained from the differences in the DDD, statistical significance, and degree of agreement in the stipulated doses. A total of 4788 prescriptions were collected. Pediatric DDD was defined for 30 different antimicrobials. A potency >80% was obtained in 24 antibiotics. 51.2% of the selected DDD correspond to Phase I and 39.5% from Phase II. Pediatric DDD of different antimicrobials was obtained, providing an indicator that can be used globally in different hospitals to analyze the consumption and efficacy of ASPs.
