[Carbapenem antibiotics in hospitalised paediatric patients. Adherence to a therapeutic protocol]

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship

Background:

• Carbapenems are broad-spectrum antibiotics crucial for treating severe infections.
• Optimizing carbapenem use is essential to combat antimicrobial resistance.
• Limited data exist on carbapenem utilization in non-critical pediatric settings.

Purpose of the Study:

• To describe carbapenem prescribing patterns in hospitalized children outside intensive care and onco-hematology units.
• To evaluate adherence to a hospital-established therapeutic protocol for carbapenem use.
• To assess the impact of the protocol on appropriate antibiotic prescription.

Main Methods:

• Retrospective observational study of pediatric patients receiving carbapenems from January 2009 to December 2010.
• Inclusion criteria: community-acquired or healthcare-associated infections in pediatric wards (excluding ICU, neonatology, onco-hematology).
• Data collection included clinical information and antibiotic consumption from the Pharmacy Department.

Main Results:

• 51 episodes met inclusion criteria; carbapenem was empirical in 31.4% and rescue therapy in the rest.
• Protocol adherence was 70.6% for empirical and 87.5% for targeted prescriptions (77.6% overall).
• Empirical carbapenem use showed better alignment with protocol in patients with prior admission or underlying conditions.

Conclusions:

• Implementation of a carbapenem treatment protocol since 2007 has significantly improved prescription appropriateness.
• The protocol demonstrates superior results compared to previously reported studies.
• This highlights the effectiveness of structured guidelines in optimizing antibiotic use in pediatric populations.