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Updated: Dec 2, 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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Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: a retrospective cohort

Yasser M Kazzaz1,2,3, Haneen AlTurki4,5, Lama Aleisa4,5

  • 1Department of Pediatrics, Ministry of National Guards - Health Affairs, Riyadh, Kingdom of Saudi Arabia. kazzazy@ngha.med.sa.

Antimicrobial Resistance and Infection Control
|November 4, 2020
PubMed

Insights

High antibiotic use in pediatric intensive care units (PICUs) is linked to antimicrobial resistance (AMR). This study found 48% of antibiotic courses were inappropriate, highlighting a need for better antibiotic stewardship programs (ASPs) to combat AMR.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Healthcare-Associated Infections

Background:

  • Inappropriate antibiotic use fuels antimicrobial resistance (AMR) and reduces susceptibility in intensive care units.
  • Antibiotic stewardship programs (ASPs) are key to mitigating AMR's impact.
  • Understanding antibiotic prescribing patterns is vital for targeted interventions.

Purpose of the Study:

  • To characterize antibiotic utilization in a tertiary care pediatric intensive care unit (PICU).
  • To quantify the appropriateness of antibiotic prescriptions within the PICU setting.

Main Methods:

  • Retrospective cohort study over 6 months in a Saudi Arabian pediatric hospital.
  • Antibiotic consumption measured by Days of Therapy (DOT) per 1000 patient-days.
  • Appropriateness assessed by two physicians using the CDC 12-step Campaign criteria.

Main Results:

  • 497 patients admitted, 3009 patient-days, 274 antibiotic courses administered.
  • 48% of antibiotic courses did not adhere to at least one CDC guideline step.
  • Inappropriate antibiotic choice and prophylaxis duration were primary issues; Cefazolin and vancomycin showed high inappropriate DOTs.

Conclusions:

  • Significant inappropriate antibiotic utilization was observed in the PICU.
  • Findings can guide decision-making for antimicrobial stewardship programs.
  • CDC steps offer an objective method for assessing antibiotic appropriateness.
Abstract

Keywords:
AntibioticsAntimicrobial resistanceAntimicrobial stewardshipChildrenDays of therapySaudi Arabia

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