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Antimicrobial prescription patterns in a tertiary-care pediatric unit in Thailand
Sineenart Chautrakarn1,2, Suvaporn Anugulruengkitt3,4, Thanyawee Puthanakit3,4
1Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Nearly half of hospitalized children received antimicrobials. High meropenem use was noted, differing from other pediatric centers. This study offers baseline antimicrobial use data for Thailand.
Area of Science:
- Pediatric pharmacology
- Infectious disease epidemiology
- Public health
Background:
- Antimicrobial resistance is a global health crisis.
- Inappropriate antibiotic prescribing fuels resistance.
- Surveillance data is crucial for antimicrobial stewardship programs.
Purpose of the Study:
- To determine antimicrobial use rates in a Thai pediatric unit.
- To analyze antimicrobial prescription patterns.
- To establish baseline data for stewardship initiatives.
Main Methods:
- Monthly point prevalence survey from January to June 2016.
- Included all pediatric inpatient beds.
- Identified children receiving antimicrobial treatment.
Main Results:
- 43.3% of 644 children received antimicrobials.
- Prescription rates varied by ward (37.2% general to 67.7% surgical).
- Meropenem and third-generation cephalosporins were frequently used.
Conclusions:
- Antimicrobial use in hospitalized children is high, similar to international benchmarks.
- Specific antimicrobial choices, like meropenem, warrant further investigation.
- Findings provide essential data for future national antimicrobial surveillance.
Background:
Antimicrobial resistance is one of the greatest public health threats worldwide. The improper prescription of antibiotics is one factor that promotes antibiotic resistance. Access to antimicrobial surveillance data is essential when assessing the pattern and appropriateness of antimicrobial prescriptions in hospitals and for the establishment of an antimicrobial stewardship program. This study aimed to describe the rate of antimicrobial use and the pattern of prescriptions in a tertiary care pediatric unit in Thailand.
Methods:
A point prevalence survey on antimicrobial use was conducted monthly between January and June 2016, using standardized tools. The survey included all inpatient pediatric beds and identified all children receiving antimicrobial treatment on the day of the survey.
Results:
The study included 644 children, 43.3% of whom received antimicrobial treatment during hospitalization. In general wards, the rate of antimicrobial prescriptions was 37.2%; in oncology wards it was 47.0%; in intensive care units it was 38.7%, and in surgical wards it was 67.7%. Meropenem was the most prescribed antimicrobial in the general wards (24.5%) and intensive care units (28.6%), whereas antipseudomonas was the most commonly prescribed antimicrobial in the oncology ward (26.6%). For the surgical ward, the most prescribed antimicrobial was third-generation cephalosporin for both prophylaxis and treatment (39.0%). The most common reason for antimicrobial use was the treatment of infections.
Conclusions:
Nearly half of hospitalized children received at least one antimicrobial. This was comparable with other pediatric tertiary care centers, although the high use of meropenem was different. This study provides important baseline information on antimicrobial use in a large tertiary-care pediatric unit and could lead to a nationwide survey in the future.
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