Cargando…

1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals

BACKGROUND: Inappropriate antimicrobial use (AMU) is strongly associated with antimicrobial resistance. The Global Point Prevalence Survey (Global-PPS) is a standardized tool that is used worldwide to characterize inpatient AMU. We report pediatric results from 26 Canadian hospitals that participate...

Descripción completa

Detalles Bibliográficos
Autores principales: Lefebvre, Marie-Astrid, Versporten, Ann, Carrier, Marie, Chang, Sandra, Comeau, Jeannette L, Emond, Yannick, Frenette, Charles, Khan, Sarah, Landry, Daniel L, MacLaggan, Timothy D, Tien Nguyen, Trong, Nguyen, Tuyen, Valiquette, Louis, Mertz, Dominik, Pauwels, Ines, Goossens, Herman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811194/
http://dx.doi.org/10.1093/ofid/ofz360.999
_version_ 1783462421982085120
author Lefebvre, Marie-Astrid
Versporten, Ann
Carrier, Marie
Chang, Sandra
Comeau, Jeannette L
Emond, Yannick
Frenette, Charles
Khan, Sarah
Landry, Daniel L
MacLaggan, Timothy D
Tien Nguyen, Trong
Nguyen, Tuyen
Valiquette, Louis
Mertz, Dominik
Pauwels, Ines
Goossens, Herman
author_facet Lefebvre, Marie-Astrid
Versporten, Ann
Carrier, Marie
Chang, Sandra
Comeau, Jeannette L
Emond, Yannick
Frenette, Charles
Khan, Sarah
Landry, Daniel L
MacLaggan, Timothy D
Tien Nguyen, Trong
Nguyen, Tuyen
Valiquette, Louis
Mertz, Dominik
Pauwels, Ines
Goossens, Herman
author_sort Lefebvre, Marie-Astrid
collection PubMed
description BACKGROUND: Inappropriate antimicrobial use (AMU) is strongly associated with antimicrobial resistance. The Global Point Prevalence Survey (Global-PPS) is a standardized tool that is used worldwide to characterize inpatient AMU. We report pediatric results from 26 Canadian hospitals that participated in the Global-PPS in 2018. METHODS: The survey was completed by each site on the Global-PPS website for all patients aged 0–17 years hospitalized in a neonatal or pediatric ward on a chosen day between January and December 2018. Data collected included ward type, demographics, antimicrobials prescribed, diagnosis, type of indication (community-acquired [CA] vs. healthcare-associated [HA]) and type of therapy (empiric vs. targeted). Quality indicators included guideline compliance, medical record documentation of diagnosis, antimicrobial stop/review date, and surgical prophylaxis (SP) duration. RESULTS: Of the 26 sites, 23 were mixed and 3 were pediatric hospitals, with data on 767 inpatients. Overall, 25.8% (n = 198) of patients received at least one antimicrobial, and 21.9% (n = 168) were on at least one antibiotic. The highest AMU was found in Hematology-Oncology (84%), Pediatric Intensive Care (55.3%) and surgical (42.1%) units. Of the 330 antimicrobial prescriptions, 40.9% were for CA infections, 23% for medical prophylaxis, 20% for HA infections and 2.7% for SP. The most commonly treated infections were sepsis (16%) and lower respiratory tract infection (12.1%). The top five prescribed antibiotics were aminopenicillins (20.4%), aminoglycosides (16.1%), third-generation cephalosporins (15.4%), piperacillin–tazobactam (7.5%) and trimethoprim-sulfamethoxazole (7.5%). Diagnosis and stop/review date were documented for 88.1% and 65.1% of prescriptions, respectively. Compliance to local guidelines was found in 91.5% of therapies. SP exceeded 24 hours in 88.9% of courses. CONCLUSION: The Global-PPS generated Canada-wide data on inpatient pediatric AMU, which will allow hospitals to benchmark and develop local quality improvement interventions to enhance appropriate AMU. Targets for improvement include suboptimal antimicrobial stop/review date documentation and prolonged SP. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6811194
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-68111942019-10-29 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals Lefebvre, Marie-Astrid Versporten, Ann Carrier, Marie Chang, Sandra Comeau, Jeannette L Emond, Yannick Frenette, Charles Khan, Sarah Landry, Daniel L MacLaggan, Timothy D Tien Nguyen, Trong Nguyen, Tuyen Valiquette, Louis Mertz, Dominik Pauwels, Ines Goossens, Herman Open Forum Infect Dis Abstracts BACKGROUND: Inappropriate antimicrobial use (AMU) is strongly associated with antimicrobial resistance. The Global Point Prevalence Survey (Global-PPS) is a standardized tool that is used worldwide to characterize inpatient AMU. We report pediatric results from 26 Canadian hospitals that participated in the Global-PPS in 2018. METHODS: The survey was completed by each site on the Global-PPS website for all patients aged 0–17 years hospitalized in a neonatal or pediatric ward on a chosen day between January and December 2018. Data collected included ward type, demographics, antimicrobials prescribed, diagnosis, type of indication (community-acquired [CA] vs. healthcare-associated [HA]) and type of therapy (empiric vs. targeted). Quality indicators included guideline compliance, medical record documentation of diagnosis, antimicrobial stop/review date, and surgical prophylaxis (SP) duration. RESULTS: Of the 26 sites, 23 were mixed and 3 were pediatric hospitals, with data on 767 inpatients. Overall, 25.8% (n = 198) of patients received at least one antimicrobial, and 21.9% (n = 168) were on at least one antibiotic. The highest AMU was found in Hematology-Oncology (84%), Pediatric Intensive Care (55.3%) and surgical (42.1%) units. Of the 330 antimicrobial prescriptions, 40.9% were for CA infections, 23% for medical prophylaxis, 20% for HA infections and 2.7% for SP. The most commonly treated infections were sepsis (16%) and lower respiratory tract infection (12.1%). The top five prescribed antibiotics were aminopenicillins (20.4%), aminoglycosides (16.1%), third-generation cephalosporins (15.4%), piperacillin–tazobactam (7.5%) and trimethoprim-sulfamethoxazole (7.5%). Diagnosis and stop/review date were documented for 88.1% and 65.1% of prescriptions, respectively. Compliance to local guidelines was found in 91.5% of therapies. SP exceeded 24 hours in 88.9% of courses. CONCLUSION: The Global-PPS generated Canada-wide data on inpatient pediatric AMU, which will allow hospitals to benchmark and develop local quality improvement interventions to enhance appropriate AMU. Targets for improvement include suboptimal antimicrobial stop/review date documentation and prolonged SP. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6811194/ http://dx.doi.org/10.1093/ofid/ofz360.999 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Lefebvre, Marie-Astrid
Versporten, Ann
Carrier, Marie
Chang, Sandra
Comeau, Jeannette L
Emond, Yannick
Frenette, Charles
Khan, Sarah
Landry, Daniel L
MacLaggan, Timothy D
Tien Nguyen, Trong
Nguyen, Tuyen
Valiquette, Louis
Mertz, Dominik
Pauwels, Ines
Goossens, Herman
1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title_full 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title_fullStr 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title_full_unstemmed 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title_short 1135. The 2018 Global Point Prevalence Survey of Antimicrobial Consumption and Resistance: Pediatric Results from 26 Canadian Hospitals
title_sort 1135. the 2018 global point prevalence survey of antimicrobial consumption and resistance: pediatric results from 26 canadian hospitals
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811194/
http://dx.doi.org/10.1093/ofid/ofz360.999
work_keys_str_mv AT lefebvremarieastrid 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT versportenann 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT carriermarie 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT changsandra 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT comeaujeannettel 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT emondyannick 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT frenettecharles 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT khansarah 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT landrydaniell 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT maclaggantimothyd 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT tiennguyentrong 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT nguyentuyen 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT valiquettelouis 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT mertzdominik 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT pauwelsines 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals
AT goossensherman 1135the2018globalpointprevalencesurveyofantimicrobialconsumptionandresistancepediatricresultsfrom26canadianhospitals