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Use of antimicrobial drugs in general hospitals: IV. Infants and children
Insights
Antimicrobial drug use was common in hospitalized children, with 22% receiving antibiotics. Penicillins were most frequent, especially ampicillin, with use varying by age and indication.
Area of Science:
- Pediatric Pharmacology
- Infectious Disease Epidemiology
Background:
- Antimicrobial drug utilization in pediatric populations requires clear understanding for effective treatment and resistance management.
- Existing data on pediatric antimicrobial prescribing patterns in general hospitals is limited.
Purpose of the Study:
- To characterize antimicrobial drug use in hospitalized pediatric patients across general hospitals.
- To establish norms of practice for antimicrobial prescribing in this demographic.
Main Methods:
- A cross-sectional study involving 933 infants and children hospitalized in 20 Pennsylvania short-stay general hospitals.
- Data collection on antimicrobial drug administration, including drug class, specific agents, indications, and culture association.
Main Results:
- Twenty-two percent of pediatric patients received antimicrobial drugs, with higher rates in older infants (57% at 12-18 months) compared to neonates (5%).
- Penicillins or analogues constituted 68% of antimicrobial courses, with ampicillin being the most frequent single agent (32%).
- Antimicrobials were primarily used for proven/suspected infections (79%) or prophylaxis (17%), with culture association varying by age.
Conclusions:
- This study establishes baseline data on antimicrobial prescribing norms in pediatric hospital settings.
- Findings highlight the predominant use of penicillins and the need for age-specific analysis of antimicrobial use.
- Further research can inform guidelines to optimize antimicrobial stewardship in pediatric care.
Abstract:
The use of antimicrobial drugs was studied among 933 randomly selected infants and children who were hospitalized in 20 short-stay general hospitals in Pennsylvania. Twenty-two percent of pediatric patients received antimicrobial drugs: 5% of neonates and 57% of patients aged 12 to 18 months. Sixty-eight percent of the 265 antimicrobial courses administered to these children consisted of a penicillin or a penicillin analogue. Ampicillin was the single drug most frequently administered and was given in 32% of all courses. In contrast to the findings in older children, penicillin or penicillin analogues and aminoglycosides were the only antimicrobial drug groups administered to neonataes. Seventy-nine percent of courses were initiated for proved or suspected infections and 17% were initiated to prevent infections associated with surgical or nonsurgical invasive procedures. Cultures were associated with the initiation of 84% of courses among neonates and 39% of courses among children 6 to 9 years of age. This study provides the initial information, from data derived from randomly selected general hospitals, to permit a statement of norms of practice with respect to use of antimicrobial drugs in pediatric populations.