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Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016
The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resist...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5617983/ https://www.ncbi.nlm.nih.gov/pubmed/28902135 http://dx.doi.org/10.3390/antibiotics6030019 |
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author | Gandra, Sumanth Singh, Sanjeev K. Jinka, Dasaratha R. Kanithi, Ravishankar Chikkappa, Ashok K. Sharma, Anita Dharmapalan, Dhanya Vasudevan, Anil Kumar Tunga, Onkaraiah Akula, Akhila Garg, Garima Hsia, Yingfen Murki, Srinivas Alvarez-Uria, Gerardo Sharland, Mike Laxminarayan, Ramanan |
author_facet | Gandra, Sumanth Singh, Sanjeev K. Jinka, Dasaratha R. Kanithi, Ravishankar Chikkappa, Ashok K. Sharma, Anita Dharmapalan, Dhanya Vasudevan, Anil Kumar Tunga, Onkaraiah Akula, Akhila Garg, Garima Hsia, Yingfen Murki, Srinivas Alvarez-Uria, Gerardo Sharland, Mike Laxminarayan, Ramanan |
author_sort | Gandra, Sumanth |
collection | PubMed |
description | The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) project, we examined the prevalence of and indications of antimicrobial use, as well as antimicrobial agents used among hospitalized children by conducting four point prevalence surveys in six hospitals between February 2016 and February 2017. A total of 681 children were hospitalized in six hospitals across all survey days, and 419 (61.5%) were prescribed one or more antimicrobials (antibacterials, antivirals, antifungals). Antibacterial agents accounted for 90.8% (547/602) of the total antimicrobial prescriptions, of which third-generation cephalosporins (3GCs) accounted for 38.9% (213/547) and penicillin plus enzyme inhibitor combinations accounted for 14.4% (79/547). Lower respiratory tract infection (LRTI) was the most common indication for prescribing antimicrobials (149 prescriptions; 24.8%). Although national guidelines recommend the use of penicillin and combinations as first-line agents for LRTI, 3GCs were the most commonly prescribed antibacterial agents (55/149 LRTI prescriptions; 36.9%). In conclusion, 61.5% of hospitalized children were on at least one antimicrobial agent, with excessive use of 3GCs. Hence there is an opportunity to limit their inappropriate use. |
format | Online Article Text |
id | pubmed-5617983 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-56179832017-09-29 Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 Gandra, Sumanth Singh, Sanjeev K. Jinka, Dasaratha R. Kanithi, Ravishankar Chikkappa, Ashok K. Sharma, Anita Dharmapalan, Dhanya Vasudevan, Anil Kumar Tunga, Onkaraiah Akula, Akhila Garg, Garima Hsia, Yingfen Murki, Srinivas Alvarez-Uria, Gerardo Sharland, Mike Laxminarayan, Ramanan Antibiotics (Basel) Article The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) project, we examined the prevalence of and indications of antimicrobial use, as well as antimicrobial agents used among hospitalized children by conducting four point prevalence surveys in six hospitals between February 2016 and February 2017. A total of 681 children were hospitalized in six hospitals across all survey days, and 419 (61.5%) were prescribed one or more antimicrobials (antibacterials, antivirals, antifungals). Antibacterial agents accounted for 90.8% (547/602) of the total antimicrobial prescriptions, of which third-generation cephalosporins (3GCs) accounted for 38.9% (213/547) and penicillin plus enzyme inhibitor combinations accounted for 14.4% (79/547). Lower respiratory tract infection (LRTI) was the most common indication for prescribing antimicrobials (149 prescriptions; 24.8%). Although national guidelines recommend the use of penicillin and combinations as first-line agents for LRTI, 3GCs were the most commonly prescribed antibacterial agents (55/149 LRTI prescriptions; 36.9%). In conclusion, 61.5% of hospitalized children were on at least one antimicrobial agent, with excessive use of 3GCs. Hence there is an opportunity to limit their inappropriate use. MDPI 2017-09-13 /pmc/articles/PMC5617983/ /pubmed/28902135 http://dx.doi.org/10.3390/antibiotics6030019 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gandra, Sumanth Singh, Sanjeev K. Jinka, Dasaratha R. Kanithi, Ravishankar Chikkappa, Ashok K. Sharma, Anita Dharmapalan, Dhanya Vasudevan, Anil Kumar Tunga, Onkaraiah Akula, Akhila Garg, Garima Hsia, Yingfen Murki, Srinivas Alvarez-Uria, Gerardo Sharland, Mike Laxminarayan, Ramanan Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title | Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title_full | Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title_fullStr | Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title_full_unstemmed | Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title_short | Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016 |
title_sort | point prevalence surveys of antimicrobial use among hospitalized children in six hospitals in india in 2016 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5617983/ https://www.ncbi.nlm.nih.gov/pubmed/28902135 http://dx.doi.org/10.3390/antibiotics6030019 |
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