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Published on: August 30, 2018
Antimicrobial Use in Pediatric Oncology and Hematology: Protocol for a Multicenter Point-Prevalence Study With
Cihan Papan1, Katharina Reifenrath2, Katharina Last1
1Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
Insights
This study evaluates antimicrobial use in pediatric cancer patients to combat resistance. Findings will guide interventions and improve antimicrobial stewardship in oncology centers.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Antimicrobial Stewardship
Background:
- Infections are a major cause of illness and death in pediatric cancer patients.
- Inappropriate antimicrobial use fuels antimicrobial resistance.
- A qualitative assessment of individual antimicrobial prescriptions is needed.
Purpose of the Study:
- To identify appropriate vs. inappropriate antimicrobial use in pediatric cancer patients.
- To report findings to participating centers and inform care quality.
- To compare local care standards with national guidelines.
Main Methods:
- A point-prevalence study was conducted at pediatric cancer centers in Germany and Austria.
- All hospitalized patients under 18 were included.
- An expert panel qualitatively assessed each antimicrobial prescription, comparing local and national guidelines.
Main Results:
- The point-prevalence survey included 30 sites as of December 2021.
- Expert panel adjudication for qualitative assessment is ongoing.
- Study results are anticipated in 2022.
Conclusions:
- This is the first study using a multistep, qualitative approach to assess antimicrobial prescriptions in pediatric cancer centers.
- Results will inform interventions for internal guidelines and stewardship programs.
- The study aims to integrate stewardship principles to improve care for pediatric cancer patients.
Background:
Because infections are a major driver of morbidity and mortality in children with hematologic or oncologic diseases, antimicrobials are frequently prescribed in pediatric oncology practice. However, excess or inappropriate use of antimicrobials is directly linked to the emergence of antimicrobial resistance. Although point-prevalence studies have examined the extent of antimicrobial use, a comprehensive qualitative evaluation of individual antimicrobial prescriptions remains lacking.
Objective:
The aim of this study is to identify appropriate versus inappropriate antimicrobial use among pediatric cancer patients in a point-prevalence study, followed by an expert panel adjudication process and a subsequent report of these findings to participating centers. This study also aims to improve the quality of patient care by informing centers about discrepancies between internal standards of care and national guidelines.
Methods:
Our point-prevalence study is performed at pediatric cancer centers in Germany and Austria. All patients under 18 years old who are hospitalized at the time of the study are included. As a supplement to the point-prevalence study, an expert panel is qualitatively assessing each of the antimicrobial prescriptions at the participating centers to review local guidelines and compare them with national guidelines.
Results:
As of December 2021, the point-prevalence survey has been conducted at 30 sites and expert panel adjudication for qualitative assessment of each antimicrobial use is ongoing. Results of the study are expected in 2022.
Conclusions:
This is the first point-prevalence study conducted among pediatric cancer centers with an integrated, multistep, qualitative approach that assesses each antimicrobial prescription. The results of this study will inform possible interventions for internal guidelines and antimicrobial stewardship programs implemented at pediatric cancer centers. In addition, local guidelines will be compared with national guidelines. Furthermore, this study will contribute to the overall integration of antimicrobial stewardship principles and initiatives in pediatric oncology and hematology, thereby improving safety and quality of care for children and adolescents with cancer and blood disorders.
International Registered Report Identifier (Irrid):
DERR1-10.2196/35774.
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