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Updated: Dec 27, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Considerable variability in antibiotic use among US children's hospitals in 2017-2018

Hannah G Griffith1, Keerti Dantuluri2, Cary Thurm3

  • 1Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.

Infection Control and Hospital Epidemiology
|March 7, 2020
PubMed

Insights

More than one-third of hospitalized children received antibiotics, and 1 in 8 received broad-spectrum antibiotics daily. Regional variations in antibiotic use highlight opportunities for improved antibiotic stewardship programs in children's hospitals.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Healthcare Epidemiology

Background:

  • Antibiotic use in hospitalized children is a significant concern due to the rise of antimicrobial resistance.
  • Understanding the prevalence and patterns of antibiotic prescribing is crucial for effective stewardship.

Purpose of the Study:

  • To determine the prevalence of antibiotic use among hospitalized children in the United States.
  • To investigate seasonal and regional variations in inpatient antibiotic prescribing.
  • To identify differences in antibiotic use across various hospital units.

Main Methods:

  • A cross-sectional study was conducted on a single day across four seasons in 2017-2018.
  • Data were collected from 51 freestanding US children's hospitals participating in the Pediatric Health Information System (PHIS).
  • Inclusion criteria comprised all patients under 18 years old admitted to participating hospitals, excluding those admitted solely for research.

Main Results:

  • Over one-third (36.3%) of 52,769 hospitalized children received antibiotics on the study day; 12.5% received broad-spectrum agents.
  • Antibiotic use prevalence varied significantly by hospital (22.3%–51.9%) and patient type (29.2% medical vs. 47.7% surgical).
  • No significant seasonal variation was observed, but regional differences were noted, with the West having the highest prevalence (40.2%). Pediatric intensive care units (PICUs) showed the highest antibiotic use (58.3%).

Conclusions:

  • A substantial proportion of hospitalized children receive antibiotics, including broad-spectrum agents, on any given day.
  • Significant variations in antibiotic prescribing exist across hospitals, regions, and patient care settings.
  • These findings underscore the need for targeted antibiotic stewardship interventions to optimize antibiotic use in pediatric healthcare settings.
Abstract

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