Measuring antibiotic prescribing in hospitalised children in resource-poor countries: a systematic review

Area of Science:

• Global Health
• Infectious Diseases
• Pharmacology

Background:

• Antibiotic resistance is a major global health threat driven by widespread antibiotic use.
• Understanding antibiotic exposure in hospitalized children, especially in resource-poor settings, is crucial but limited.
• Infectious diseases disproportionately affect children in resource-limited regions.

Purpose of the Study:

• To systematically review and quantify antibiotic use in hospitalized children in resource-poor countries.
• To identify gaps in research methodology and data collection regarding pediatric antibiotic exposure.
• To highlight the need for standardized surveillance of antimicrobial prescribing.

Main Methods:

• Systematic literature search across multiple databases (MEDLINE, CINAHL, EMBASE, LILACS, African Index Medicus).
• Inclusion of original research studies quantifying antibiotic use in hospitalized children.
• Analysis of methodologies, with a focus on the use of defined daily dose (DDD).

Main Results:

• Eighteen relevant studies were identified, exhibiting considerable methodological variation.
• Only seven studies utilized a recognized defined daily dose (DDD) methodology.
• Hospitalized children in these settings demonstrated high exposure to antibiotics.
• Data quality and comparability were limited, particularly outside of China.

Conclusions:

• There is a significant lack of standardized data on antibiotic use in hospitalized children in resource-poor countries.
• A simplified, standardized pediatric DDD methodology is essential for international comparison and surveillance.
• Establishing an international surveillance network for antimicrobial prescribing and resistance is a critical goal.