Use of multiple metrics to assess antibiotic use in Italian children's hospitals

Area of Science:

• Pediatric Pharmacology
• Infectious Diseases
• Health Services Research

Background:

• Antibiotic stewardship programs (ASPs) are crucial for optimizing antibiotic use.
• Accurate quantification of antibiotic utilization is essential for effective ASPs.
• Traditional metrics like DDDs may not accurately reflect pediatric antibiotic use due to age-related differences in dosing.

Purpose of the Study:

• To quantify inpatient antibiotic utilization in children using various metrics.
• To compare patient-defined doses (PDDs) with defined daily doses (DDDs).
• To evaluate the suitability of DOTs, LOTs, and PDDs as alternatives to DDDs in pediatric populations.

Main Methods:

• A multicentric study involving hospitalized children.
• Data collection included patient demographics, clinical data, and antibiotic administration records.
• Metrics evaluated included point prevalence of antibiotic use, DOTs, LOTs, PDDs, and comparison of PDDs to DDDs.

Main Results:

• 380 out of 810 (46.9%) hospitalized children received antibiotics.
• Prevalence of antibiotic use was 27.0% for prophylaxis and 20.7% for treatment.
• PDDs increased with age and only approached DDDs in children aged ≥10 years, with significant variations across antibiotic classes.

Conclusions:

• DOT, LOT, and PDD are more appropriate metrics than DDDs for quantifying antibiotic use in children.
• These alternative metrics better account for age-specific dosing and utilization patterns in pediatric patients.
• Implementing these metrics can enhance antibiotic stewardship efforts in pediatric healthcare settings.