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Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil

  • André Ricardo Araujo da SilvaEmail author
  • Elena Jaszkowski
  • Tilmann Schober
  • Ulrich von Both
  • Melanie Meyer-Buehn
  • Amanda Fáris Marques
  • Beatriz Farkas
  • Bernardo Silva de Abreu
  • Clara Biscaia di Biase
  • Jully Miyoshi Takahashi
  • Luisa Dutra de Castro
  • Izabel Alves Leal
  • Cristiane Henriques Teixeira
  • Claudia Franziska Nussbaum
  • Florian Hoffmann
  • Johannes Hübner
Original Article

Abstract

Antibiotic consumption (AC) is a key component of antimicrobial stewardship programs to recognize local patterns of antibiotic use. Our aim was to measure AC in neonatal units, including neonatal (NICU)/paediatric (PICU) intensive care units in different countries. We conducted a multicenter, retrospective, cohort study in three NICUs, one neonatal ward, and three PICUs with a total of 84 beds. Global and individual AC in days of therapy (DOT) and DOT per 1000 patient-days were assessed. During the study period, 2567 patients were admitted, corresponding to 4961 patient-days in neonatal units and 9243 patient-days in PICUs. Multidrug-resistant Gram-negative bacteria and methicillin-resistant Staphylococcus aureus were more frequent in Brazil than in Germany. Average AC was 386.5 and 1335.5 DOT/1000PD in German and Brazilian neonatal units, respectively. Aminopenicillins plus 3rd generation cephalosporins were the most commonly prescribed antibiotics in German neonatal units, while aminopenicillins plus aminoglycosides were the class most commonly used in Brazilian NICU. Average AC was 888.1 and 1440.7 DOT/1000PD in German and Brazilian PICUs, respectively. Antipseudomonal penicillins were most commonly used in the German PICU, and glycopeptides were the most frequently prescribed in Brazilian PICUs. Carbapenems represented 2.3–14% of total DOTs in German neonatal units and 4% in the Brazilian NICU and 13.0% in the German PICU and 6–12.2% in Brazilian PICUs. We concluded that different patterns of most commonly prescribed antibiotics were observed in neonatal units and PICUs in these two countries, probably related to different local patterns of antibiotic resistance, with a higher antibiotic consumption in Brazilian study units.

Keywords

Antimicrobial consumption Paediatric intensive care unit Neonatal intensive care unit 

Notes

Acknowledgments

We thank ME Guimarães Viana (Director of Prontobaby and Centro Pediátrico da Lagoa) for your support.

Compliance with ethical standards

Conflict of interest

The authors declared that they have no conflict of interest.

Ethical approval

Formal ethical approval was obtained from the research ethics committee of the LMU Munich (ID 404-14) and national Brazilian Committee (CAEE 69902317.3.0000.5243, 15/09/2017)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • André Ricardo Araujo da Silva
    • 1
    Email author
  • Elena Jaszkowski
    • 2
  • Tilmann Schober
    • 2
  • Ulrich von Both
    • 2
  • Melanie Meyer-Buehn
    • 2
  • Amanda Fáris Marques
    • 3
  • Beatriz Farkas
    • 3
  • Bernardo Silva de Abreu
    • 3
  • Clara Biscaia di Biase
    • 3
  • Jully Miyoshi Takahashi
    • 3
  • Luisa Dutra de Castro
    • 3
  • Izabel Alves Leal
    • 3
  • Cristiane Henriques Teixeira
    • 3
  • Claudia Franziska Nussbaum
    • 4
  • Florian Hoffmann
    • 5
  • Johannes Hübner
    • 2
  1. 1.Materno-Infantil Departament, Faculdade de MedicinaUniversidade Federal FluminenseNiteróiBrazil
  2. 2.Infectiology ServiceDr. von Hauner Children’s Hospital, LMU MunichMunichGermany
  3. 3.Teaching Laboratory of Prevention and Control of Healthcare-Associated Infections, Faculdade de MedicinaUniversidade Federal FluminenseNiteróiBrazil
  4. 4.Neonatal Medicine ServiceDr. von Hauner Children’s Hospital, LMU MunichMunichGermany
  5. 5.Intensive Care Medicine serviceDr. von Hauner Children’s Hospital, LMU MunichMunichGermany

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