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Antimicrobial consumption in a tertiary children's hospital in Finland (2003-2013)
Niina Laine1,2, Kalle Hoppu3, Marja Airaksinen2
1Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Insights
Antimicrobial drug use in a children's hospital increased, particularly carbapenems, while novel antifungal use rapidly rose. Prudent antimicrobial stewardship remains crucial amid rising resistant pathogens.
Area of Science:
- Pediatric pharmacology
- Infectious disease epidemiology
- Antimicrobial stewardship
Background:
- Rising antimicrobial resistance necessitates prudent drug use.
- Monitoring antimicrobial consumption is vital to understand trends.
- A tertiary pediatric hospital was chosen for this study.
Purpose of the Study:
- To analyze changes in antimicrobial drug consumption over a decade.
- To identify trends in antibacterial and antifungal agent usage.
- To inform antimicrobial stewardship practices in pediatric care.
Main Methods:
- Retrospective analysis of antimicrobial consumption from 2003-2013.
- Data collected using electronic surveillance records from a single pediatric tertiary hospital.
- Consumption measured in defined daily doses (DDD) per days of hospital care.
Main Results:
- Penicillin, cephalosporin, and carbapenem use increased by 28%, 46%, and 110%, respectively.
- Aminoglycoside and vancomycin consumption decreased by 61% and 41%.
- Novel azole and echinocandin use increased, while amphotericin B decreased.
Conclusions:
- Increased carbapenem use was a significant finding.
- Antibacterial use remained relatively stable, with conservative adoption of new agents.
- Novel antifungals were rapidly adopted despite limited pediatric safety data.
Background:
Numbers of resistant pathogens are constantly increasing, and prudent use of antimicrobials is of paramount importance. In order to see whether any changes in the use of antimicrobials in recent years have occurred, we decided to monitor the consumption of these drugs at a single tertiary paediatric hospital.
Materials And Methods:
This single-centre retrospective study investigated the consumption of antimicrobials in defined daily doses (DDDs according to the Anatomical Therapeutical Chemical /DDD index) in a 130-bed paediatric tertiary hospital. The data on the consumption of antimicrobials were collected from years 2003-2013 by using electronic surveillance records provided by the local pharmacy. The consumption was related to days of hospital care.
Results:
During 2003-2013, the use of penicillins, cephalosporins and carbapenems increased by 28%, 46% and 110%, respectively. The consumption of both aminoglycosides and vancomycin decreased by 61% and 41%, respectively. Amphotericin B use clearly decreased by 39% while the use of novel azoles and echinocandins increased.
Conclusions:
Increased use of carbapenems was the most significant finding of our study. The year-to-year consumption of antibacterials was in general relatively stable and new antibacterials were taken into use conservatively. In contrast to antibacterials, novel antifungals were rapidly adopted into use despite scarce evidence on their safety in children.