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Updated: Jul 6, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

A controlled intervention study to improve antibiotic use in a Russian paediatric hospital

Dag Berild1, Tore G Abrahamsen, Stein Andresen

  • 1Department of Infectious Diseases, Aker University Hospital, Oslo, Norway. dag.berild@medisin.uio.no

International Journal of Antimicrobial Agents
|March 18, 2008
PubMed

Insights

Implementing antibiotic guidelines in a pediatric hospital reduced antibiotic use significantly. However, antibiotic prescribing nearly returned to baseline levels one year later, highlighting the need for sustained interventions.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Public Health Interventions

Background:

  • Antibiotic overuse is a significant global health concern, particularly in pediatric populations.
  • Optimizing antibiotic prescribing practices is crucial for combating antimicrobial resistance and improving patient outcomes.
  • Previous interventions have shown varying success in sustaining improvements in antibiotic use.

Purpose of the Study:

  • To evaluate the impact of implementing clinical guidelines on antibiotic use in pediatric gastrointestinal infections (GII) and respiratory tract infections (RTI).
  • To assess the persistence of improved antibiotic prescribing practices over time.
  • To determine if changes in antibiotic use affected patient outcomes.

Main Methods:

  • A controlled intervention study was conducted in a Russian pediatric hospital.
  • Guidelines for diagnosis and treatment were implemented in intervention wards (one GII, one RTI) in 2003.
  • Data on clinical outcomes, microbiological data, antibiotic use, and costs were collected in intervention and control wards during 2002, 2003, and 2004.

Main Results:

  • Antibiotic use in intervention wards decreased significantly in 2003 (GII: 94% to 41%; RTI: 90% to 53%) compared to controls.
  • By 2004, antibiotic use increased but remained lower than pre-intervention levels (GII: 73%; RTI: 83%).
  • No significant differences in mortality, fever duration, or hospital stay were observed between groups; cephalosporin use decreased while penicillin use increased for pneumonia.

Conclusions:

  • Antibiotic use in pediatric GII and RTI can be substantially reduced without compromising patient care quality.
  • The positive effects of the intervention on antibiotic prescribing diminished within one year, indicating a need for strategies to ensure long-term adherence.
  • Sustained antimicrobial stewardship programs are essential for maintaining improvements in antibiotic use in pediatric settings.

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