Assessment of Antimicrobial Consumption in Multi-Field Hospitals with Pediatric Inpatients: Conventional vs. Novel...

Area of Science:

• Pharmacoeconomics
• Pediatric Pharmacology
• Health Services Research

Background:

• Accurate assessment of antimicrobial consumption (AMC) is crucial, especially in pediatric populations.
• Conventional methodologies may underestimate AMC in pediatric inpatients.
• Variances in AMC estimation exist between different hospital settings.

Purpose of the Study:

• To propose a novel methodology for assessing AMC in pediatric inpatients.
• To estimate consumption level variances using a pediatric-adjusted approach versus conventional methods.
• To evaluate the accuracy of AMC estimation in multi-field hospitals with pediatric patients.

Main Methods:

• Developed a pediatric-adjusted methodology using the Anatomical Therapeutic Chemical (ATC) classification system and children's defined daily doses (cDDD).
• Validated the methodology through probabilistic sensitivity analyses using real clinical data from three multi-field hospitals.
• Assessed differences in AMC using the proposed and conventional methods in a virtual cohort with varying pediatric patient shares.

Main Results:

• The proposed methodology resulted in a 25% underestimation of AMC in children ≤12 years old, compared to 59% with the standard method.
• In a mixed-age virtual population, the conventional ATC/DDD methodology underestimated consumption by 321% relative to the proposed method.
• The pediatric-adjusted methodology demonstrated significantly higher accuracy in AMC estimation.

Conclusions:

• The proposed methodology offers improved accuracy for estimating antimicrobial consumption in pediatric settings.
• This approach is suitable for quantifying antimicrobial utilization in pediatric institutions and mixed-age hospitals.
• Enhanced AMC assessment can inform antimicrobial stewardship programs and improve patient care.