Skip to main content
SpringerLink
Log in

Implementation of Hospital’s Antibiotic Policy Decreases Antimicrobial Use in the General Pediatric Ward

  • Chapter
  • First Online:
Pulmonary Infection

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 857))

Abstract

Hospitalized children are often treated with antibiotics. However, 30–75 % of antibiotic treatment in pediatric hospitals is administrated incorrectly or unreasonably. Implementation of Hospital’s Antibiotic Policy (HAP) should improve antibiotic consumption patterns in pediatric wards. The objective of this study was to determine the effectiveness of HAP by assessing antibiotic consumption in the General Pediatric Ward of an academic hospital in the city of Warsaw, Poland before and after this policy was introduced in the years 2012 and 2013, respectively. Antibiotic use was calculated in daily-defined doses (DDDs) per 100 patient-days and DDDs per 100 admissions. Antibiotics were ranked by the volume of DDDs and the number of antibiotics which accounted for 90 % and 100 % of the total volume: DU90% and DU100% (where DU stands for drug use). The total antibiotic consumption and significantly decreased after the implementation of HAP; DDDs were 2,177.5 before and 1,335.4 after implementation of HAP. The number of DDDs/100 patient-days was also lower; 36.3 vs. 24.9 before and after HAP, respectively. After implementation of HAP a decreased use of ceftriaxone and cefuroxime was observed. The most commonly used antibiotic was amoxicillin with clavulanic acid. The DU100% rates remained the same (8 antibiotics) and DU90% increased (from 3 in 2012 to 5 in 2013). We conclude that implementation of HAP resulted a decreased consumption of antibiotics in the General Pediatric Ward, despite the hardly changed number of children treated with antibiotics.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AAP:

American Academy of Pediatrics

ATC:

Anatomical Therapeutic Chemical Classification

CAP:

Community-acquired pneumonia

CDC:

Centers for Disease Control and Prevention

DDDs:

Daily-defined doses

DU90%:

90 % drug utilization

DU100%:

100 % drug utilization

IDSA:

Infectious Diseases Society of America

HAP:

Hospital Antibiotic Policy

NPAP:

National Program of Antibiotic Protection

PIDS:

Pediatric Infectious Disease Society

SHEA:

Society of Healthcare Epidemiology of America

WHO:

World Health Organization

References

  • Ang L, Laskar R, Gray JW (2008) A point prevalence study of infection and antimicrobial use at a UK children’s hospital. J Hosp Infect 68:372–374

    Article  CAS  PubMed  Google Scholar 

  • Atti ML, Raponi M, Tozzi E, Ciliento G, Ceradini J, Langiano T (2008) Point prevalence study of antibiotic use in a paediatric hospital in Italy. Eurosurevillance 13:1–4

    Google Scholar 

  • Benin AL, Vitkauskas G, Thornquist E (2003) Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful role for the electronic medical record. Pediatr Infect Dis J 22:1043–1047

    Article  PubMed  Google Scholar 

  • Bergman U, Popa C, Tomson Y (1998) Drug utilization 90% – a simple method for assessing the quality of drug prescribing. Eur J Clin Pharmacol 54:113–118

    Article  CAS  PubMed  Google Scholar 

  • Berild D, Abrahamsen TG, Andresen S, Bjørløw E, Haug O, Kossenko IM (2008) A controlled intervention study to improve antibiotic use in a Russian paediatric hospital. Int J Antimicrob Agents 31:478–483

    Article  CAS  PubMed  Google Scholar 

  • Blinova E, Lau E, Bitnun A, Cox P, Schwartz S, Atenafu E, Yau Y, Streitenberger L, Parshuram C, Marshall J, Seto W (2013) Point prevalence survey of antimicrobial utilization in the cardiac and pediatric critical care. Pediatr Crit Care Med 14:280–288

    Article  Google Scholar 

  • Bradley JS, Byington CL, Shah SS (2011) The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis 53:e25–e76

    Article  PubMed  Google Scholar 

  • Bruce CM, Kenzie FM, Cookson B, Mollison J, van der Meer J, Kracmery V, Dould I (2009) Antibiotic stewardship and consumption: findings from a pan-European hospital study. J Antimicrob Chemother 64:853–860

    Article  CAS  PubMed  Google Scholar 

  • Cars O, Molstad S, Melander A (2001) Variation in antibiotic use in the European Union. Lancet 357:1851–1853

    Article  CAS  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC) (2012) Get smart: know when antibiotics work. For healthcare providers. Centers for Disease Control and Prevention. http://www.ded.gov/getsmart/specific-groups/hcp/index.html. Accessed on 1 Oct 2014

  • de Boeck K, Vermeulen F, Meyts I, Hutsebaut L, Franckaert D, Proesmans M (2011) Coprescription of antibiotics and asthma drugs in children. Pediatrics 127:1022–1026

    Article  PubMed  Google Scholar 

  • de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN (2000) An antibiotic policy to prevent emergence of resistant bacilli. Lancet 355:973–978

    Article  PubMed  Google Scholar 

  • di Pentima M, Chan S, Hossain J (2011) Benefits of a pediatric antimicrobial stewardship program at a children’s hospital. Pediatrics 128:1062–1070

    Article  PubMed  Google Scholar 

  • Gaur AH, Hare ME, Shorr RI (2005) Provider and practice characteristics associated with antibiotic use in children with presumed viral respiratory tract infections. Pediatrics 115:635–641

    Article  PubMed  Google Scholar 

  • Grohskopf L, Huskins W, Sinkowitz-Cochran R, Levine G, Goldmann D, Jarvis W (2005) Use of antimicrobial agents in United States neonatal and pediatric intensive care patients. Pediatr Infect Dis 24:766–773

    Article  Google Scholar 

  • Hajdu A, Samodova OV, Carlsson TR, Voinova LV, Nazarenko SJ, Tjurikov AV (2007) A point prevalence survey of hospital-acquired infections and antimicrobial use in a paediatric hospital in north-western Russia. J Hosp Infect 66:378–384

    Article  CAS  PubMed  Google Scholar 

  • Hryniewicz W, Ozorowski T (2011) Hospital antibiotic policy. Proposals for Polish hospitals. http://www.antybiotyki.edu.pl. Accessed on 12 July 2014

  • Hyun D, Hersh A, Namtu K, Palazzi D, Maples D, Newland J, Saiman L (2013) Antimicrobial stewardship in pediatrics. How every pediatrician can be a steward. J Am Med Assoc Pediatr 167:859–866

    Google Scholar 

  • Katakam P, Elfituri A, Ramadan Z, Abadi O (2012) A retrospective study on antibiotic use in different clinical departments of a teaching hospital in Zawiya, Libya. Ibnosina J Med Biomed Sci 12:13–19

    Google Scholar 

  • Kuster SP, Ruef C, Ledergerber B (2008) Quantitative antibiotic use in hospitals: comparison of measurements, literature review, and recommendations for a standard of reporting. Infection 36:549–559

    Article  CAS  PubMed  Google Scholar 

  • Levy E, Swami S, Dubois S, Wendt R, Banerjee R (2012) Rates and appropriateness of antimicrobial prescribing at the academic children’s hospital, 200702010. Infect Control Hosp Epidemiol 33:346–353

    Article  CAS  PubMed  Google Scholar 

  • Liem TB, Krediet T, Fleer A, Agberts T, Rademaker C (2010) Variation in antibiotic use in neonatal intensive care units in the Netherlands. J Antimicrob Chemother 14:245–247

    Google Scholar 

  • National Programme for Antibiotic Prevention (NPAP) (2011) http://www.antybiotyki.edu.pl/pdf/RekomendacjeA42009.pdf. Accessed on 12 Oct 2014

  • Nitsch-Osuch A, Kurpas D, Kuchar E, Życińska K, Wardyn K (2015) Antibiotic consumption pattern in the neonatal special care unit before and after implementation of the Hospital’s Antibiotic Policy. Adv Exp Med Biol 835:45–51

    CAS  PubMed  Google Scholar 

  • Ohl C, Luther V (2011) Antimicrobial stewardship for inpatient facilities. J Hosp Med 11:S4–S15

    Article  Google Scholar 

  • Palcevski G, Ahel V, Vlahovic-Palcevski V (2004) Antibiotic use profile at paediatric clinics in two transitional countries. Pharmacoepidemiol Drug Saf 13:181–185

    Article  PubMed  Google Scholar 

  • Papaevangelou V, Rousounides A, Hadjipanagis A, Katsioulis A, Theodoridou M, Hadjichristodoulou C (2012) Decrease of antibiotic consumption in children with upper respiratory tract infections after implementation of an intervention program in Cyprus. Antimicrob Agent Chemother 56:1658–1661

    Article  CAS  Google Scholar 

  • Potocki M, Goette J, Szucs TD, Nadal D (2003) Prospective survey of antibiotic utilization in pediatric hospitalized patients to identify targets for improvement of prescription. Infection 31:398–403

    CAS  PubMed  Google Scholar 

  • Principi N, Marchisio P, Sher D, Boccazzi A, Moresco RC, Viola G, Sereni F (1981) Control of antibiotic therapy in paediatric patients. II. Appropriateness of antibiotic choice in selected diseases. Eur J Clin Pharmacol 20:119–121

    Article  CAS  PubMed  Google Scholar 

  • Rossignoli A, Clavenna A, Bonati M (2007) Antibiotic prescription and prevalence rate in the outpatient pediatric population: analysis of surveys published during 2000–2005. Eur J Clin Pharmacol 63:1099–1106

    Article  PubMed  Google Scholar 

  • Schollenberg E, Albritton WL (1980) Antibiotic misuse in a pediatric teaching hospital. Can Med Assoc J 122:49–52

    CAS  PubMed Central  PubMed  Google Scholar 

  • Shehab N, Patel PR, Srinivasan A, Budnitz DS (2008) Emergency department visits for antibiotic-associated adverse events. Clin Infect Dis 47:735–743

    Article  PubMed  Google Scholar 

  • Stallworth LE, Fick DM, Ownby DR, Waller JL (2005) Antibiotic use in children who have asthma: results of retrospective database analysis. J Manag Care Pharmacol 11:657–666

    Google Scholar 

  • Stichele RH, Elseviers MM, Ferech M, Blot S, Goossens H, European Surveillance of Antibiotic Consumption (ESAC) Project Group (2006) Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997–2002). J Antimicrob Chemother 58:159–167

    Article  Google Scholar 

  • Svestina I, Mozgis D (2014) Antimicrobial use among hospitalized children in Latvia: a neonatal and pediatric antimicrobial point prevalence study. Medicine 12:111–119

    Google Scholar 

  • van Houten MA, Luinge K, Laseur M, Kimpen JL (1998) Antibiotic utilization for hospitalized paediatric patients. Int J Antimicrob Agents 10:161–164

    Article  PubMed  Google Scholar 

  • Zhang W, Shen X, Bergman U (2008) Drug utilization 90% (DU90%) profiles of antibiotics in five Chinese children’s hospitals (2002–2006). Int J Antimicrob Agents 32:250–255

    Article  CAS  PubMed  Google Scholar 

Download references

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

  1. Department of Family Medicine, Warsaw Medical University, 1A Banacha St., 02-097, Warsaw, Poland

    Aneta Nitsch-Osuch, K. Życińska & E. Gyrczuk

  2. Department of Pediatric Infectious Diseases, Wroclaw Medical University, Warsaw, Poland

    E. Kuchar & K. Miśkiewicz

  3. Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, Warsaw, Poland

    K. Korzeniewski

Authors
  1. Aneta Nitsch-Osuch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Kuchar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Życińska
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Gyrczuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Miśkiewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. Korzeniewski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aneta Nitsch-Osuch .

Editor information

Editors and Affiliations

  1. University of Opole Institute of Psychology, Opole, Poland

    Mieczyslaw Pokorski

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Nitsch-Osuch, A., Kuchar, E., Życińska, K., Gyrczuk, E., Miśkiewicz, K., Korzeniewski, K. (2015). Implementation of Hospital’s Antibiotic Policy Decreases Antimicrobial Use in the General Pediatric Ward. In: Pokorski, M. (eds) Pulmonary Infection. Advances in Experimental Medicine and Biology(), vol 857. Springer, Cham. https://doi.org/10.1007/5584_2015_124

Download citation

Publish with us

Policies and ethics

Search

Navigation