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Carbapenem stewardship program in a French university children's hospital

E Pauquet1, M Coppry1, J Sarlangue1

  • 1Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33000 Bordeaux, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|October 23, 2021
PubMed

Insights

An antibiotic stewardship program (ASP) improved carbapenem use in pediatric patients with extended-spectrum beta-lactamases (ESBL) Enterobacteriaceae. The intervention enhanced prescription compliance and reassessment, reducing overall consumption.

Area of Science:

  • Infectious Diseases
  • Pediatric Pharmacology
  • Antimicrobial Stewardship

Background:

  • Carbapenems are crucial for treating infections caused by extended-spectrum beta-lactamases (ESBL) Enterobacteriaceae.
  • Optimizing carbapenem use, especially in pediatric settings, is essential for antimicrobial stewardship.
  • Antibiotic stewardship programs (ASPs) are vital for managing last-resort antibiotics.

Purpose of the Study:

  • To implement and evaluate an ASP aimed at improving carbapenem prescribing practices in a pediatric hospital.
  • To assess the impact of the ASP on carbapenem consumption and adherence to treatment guidelines.

Main Methods:

  • An ASP was implemented at a children's hospital, involving protocol revisions and educational interventions.
  • Prescribing practices were audited over two 6-month periods, before and after the intervention.
  • Conformity of carbapenem prescription indications and reassessments was evaluated using logistic regression, adjusted for ESBL carriage.

Main Results:

  • Carbapenem consumption decreased from 0.54 to 0.32 prescriptions per 100 admissions.
  • Conformity for prescription indications significantly improved from 46% to 87% (p=0.004).
  • Conformity for reassessment significantly improved from 48% to 78% (p=0.04).

Conclusions:

  • The implemented ASP significantly enhanced compliance with carbapenem indications.
  • The intervention led to improved reassessment of carbapenem prescriptions in pediatric patients.
  • ASPs are effective in optimizing the use of last-resort antibiotics like carbapenems.
Abstract

Keywords:
Antimicrobial resistanceAntimicrobial stewardship programCarbapenemasesCarbapenemsExtended-spectrum beta-lactamase-producing enterobacteriaceaepediatric

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