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Acta Paediatr. 2015 Jul;104(7):687-92. doi: 10.1111/apa.12994. Epub 2015 Apr 1.

A worrying trend in weight-adjusted paediatric antibiotic use in a Norwegian tertiary care hospital.

Author information

1
Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
3
The Norwegian Computing Center, Oslo, Norway.
4
Department of Pediatrics, Oslo University Hospital, Oslo, Norway.
5
Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway.
6
Microbiology Section, Laboratory Centre, Vestre Viken Hospital Trust, Rud, Norway.
7
Department of Microbiology, Oslo University Hospital, Oslo, Norway.

Abstract

AIM:

The World Health Organization recommends the defined daily dose (DDD) as the standard unit of measurement for antibiotic use, but this is not applicable in children. We aimed to assess paediatric antibiotic use in a Norwegian tertiary care hospital using a novel weight-adjusted method.

METHODS:

We obtained antibiotic purchase data from the hospital pharmacy and administrative data for all admissions from 2002 to 2009 to the paediatric wards at Oslo University Hospital, Rikshospitalet. Recommended daily doses per 100 kg days (RDDs/kg days) were calculated based on national guidelines for paediatric antibiotic use, length of stay and estimated weight for sex and age using national growth references.

RESULTS:

Total antibiotic use increased significantly from 51.8 to 65.5 RDDs/100 kg days. We found statistically significant annual increases in the consumption of carbapenems (18.0%), third-generation cephalosporins (6.0%) and imidazole derivatives (6.6%) and a considerable difference between total antibiotic use measured in RDDs/100 kg days and DDDs/100 bed days for neonates.

CONCLUSION:

Weight-adjusted antibiotic use provided a more meaningful description of the quantities of antibiotics consumed than DDDs/100 bed days, particularly for neonates. Total antibiotic use, use of meropenem, third-generation cephalosporins and imidazole derivatives increased significantly despite low prevalence of antibiotic-resistant pathogens.

KEYWORDS:

Antibacterial agents; Defined daily dose; Drug utilisation; Hospitalised children; Recommended daily dose

PMID:
25753620
DOI:
10.1111/apa.12994
[Indexed for MEDLINE]

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