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Aminoglycoside use in a pediatric hospital: there is room for improvement-a before/after study

Mélanie Houot1, Benoit Pilmis2, Valérie Thepot-Seegers3

  • 1Pharmacy Department, CHU Necker-Enfants Malades, 149 rue de Sèvres, Paris, France.

European Journal of Pediatrics
|January 22, 2016
PubMed

Insights

Aminoglycoside antibiotic prescriptions in children were rarely evaluated. A simple information campaign did not improve prescribing practices, indicating a need for active monitoring to optimize pediatric use and reduce toxicity risks.

Area of Science:

  • Pediatric pharmacology
  • Infectious disease management
  • Antibiotic stewardship

Background:

  • Aminoglycoside misuse is common in adult hospitals due to nephrotoxicity and narrow therapeutic index.
  • Pediatric data on aminoglycoside prescription practices and the impact of interventions are limited.
  • Understanding prescribing patterns is crucial for optimizing treatment and minimizing adverse effects in children.

Purpose of the Study:

  • To evaluate aminoglycoside prescription patterns in a pediatric hospital.
  • To assess the impact of an information campaign on prescription and monitoring practices.
  • To identify areas for improvement in aminoglycoside use in pediatric care.

Main Methods:

  • Prospective, before-and-after study design over six months.
  • Analysis of computerized aminoglycoside prescriptions.
  • Semi-passive diffusion of local prescribing recommendations to healthcare providers.

Main Results:

  • 310 prescriptions analyzed; common infections included joint-bone, urinary tract, and intra-abdominal.
  • 12-13% of prescriptions were deemed avoidable.
  • Despite improvements, 45% of post-intervention doses remained below recommended levels (77% pre-intervention).

Conclusions:

  • Semi-passive diffusion of recommendations did not significantly improve aminoglycoside prescribing practices.
  • Practitioner misunderstanding of pharmacokinetic/pharmacodynamic targets was identified.
  • Active diffusion strategies with regular monitoring are likely necessary to enhance aminoglycoside use in pediatric settings.
Abstract

Keywords:
AminoglycosidesAuditInformation campaignPediatrics

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