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Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?

Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to...

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Autores principales: Fresán-Ruiz, Elena, Izurieta-Pacheco, Ana Carolina, Girona-Alarcón, Mònica, de Carlos-Vicente, Juan Carlos, Bustinza-Arriortua, Amaya, Slocker-Barrio, María, Belda-Hofheinz, Sylvia, Nieto-Moro, Montserrat, Uriona-Tuma, Sonia María, Pinós-Tella, Laia, Morteruel-Arizcuren, Elvira, Schuffelmann, Cristina, Peña-López, Yolanda, Bobillo-Pérez, Sara, Jordan, Iolanda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222022/
https://www.ncbi.nlm.nih.gov/pubmed/35740839
http://dx.doi.org/10.3390/children9060902
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author Fresán-Ruiz, Elena
Izurieta-Pacheco, Ana Carolina
Girona-Alarcón, Mònica
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
author_facet Fresán-Ruiz, Elena
Izurieta-Pacheco, Ana Carolina
Girona-Alarcón, Mònica
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
author_sort Fresán-Ruiz, Elena
collection PubMed
description Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over a 3-month period each year (1 April–30 June) from 2014–2019. To make comparisons and evaluate the influence of AMS programs on antibiotic use in PICUs, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once 84% of the units had incorporated an AMS program). A total of 11,260 pediatric patients were included. Total antibiotic prescriptions numbered 15,448 and, overall, 8354 patients (74.2%) received at least one antibiotic. Comparing the two periods, an increase was detected in the number of days without antibiotics in patients who received them divided by the number of days in PICUs, for community-acquired infections (p < 0.001) and healthcare-associated infections (HAIs) acquired in PICUs (p < 0.001). Antibiotics were empirical in 7720 infections (85.6%), with an increase in appropriate antibiotic indications during the second period (p < 0.001). The main indication for antibiotic adjustment was de-escalation, increasing in the second period (p = 0.045). Despite the high rate of antibiotic use in PICUs, our results showed a significant increase in appropriate antibiotic use and adjustment following the implementation of AMS programs.
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spelling pubmed-92220222022-06-24 Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned? Fresán-Ruiz, Elena Izurieta-Pacheco, Ana Carolina Girona-Alarcón, Mònica de Carlos-Vicente, Juan Carlos Bustinza-Arriortua, Amaya Slocker-Barrio, María Belda-Hofheinz, Sylvia Nieto-Moro, Montserrat Uriona-Tuma, Sonia María Pinós-Tella, Laia Morteruel-Arizcuren, Elvira Schuffelmann, Cristina Peña-López, Yolanda Bobillo-Pérez, Sara Jordan, Iolanda Children (Basel) Article Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over a 3-month period each year (1 April–30 June) from 2014–2019. To make comparisons and evaluate the influence of AMS programs on antibiotic use in PICUs, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once 84% of the units had incorporated an AMS program). A total of 11,260 pediatric patients were included. Total antibiotic prescriptions numbered 15,448 and, overall, 8354 patients (74.2%) received at least one antibiotic. Comparing the two periods, an increase was detected in the number of days without antibiotics in patients who received them divided by the number of days in PICUs, for community-acquired infections (p < 0.001) and healthcare-associated infections (HAIs) acquired in PICUs (p < 0.001). Antibiotics were empirical in 7720 infections (85.6%), with an increase in appropriate antibiotic indications during the second period (p < 0.001). The main indication for antibiotic adjustment was de-escalation, increasing in the second period (p = 0.045). Despite the high rate of antibiotic use in PICUs, our results showed a significant increase in appropriate antibiotic use and adjustment following the implementation of AMS programs. MDPI 2022-06-16 /pmc/articles/PMC9222022/ /pubmed/35740839 http://dx.doi.org/10.3390/children9060902 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fresán-Ruiz, Elena
Izurieta-Pacheco, Ana Carolina
Girona-Alarcón, Mònica
de Carlos-Vicente, Juan Carlos
Bustinza-Arriortua, Amaya
Slocker-Barrio, María
Belda-Hofheinz, Sylvia
Nieto-Moro, Montserrat
Uriona-Tuma, Sonia María
Pinós-Tella, Laia
Morteruel-Arizcuren, Elvira
Schuffelmann, Cristina
Peña-López, Yolanda
Bobillo-Pérez, Sara
Jordan, Iolanda
Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title_full Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title_fullStr Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title_full_unstemmed Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title_short Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain—What Have We Learned?
title_sort antimicrobial stewardship improvement in pediatric intensive care units in spain—what have we learned?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222022/
https://www.ncbi.nlm.nih.gov/pubmed/35740839
http://dx.doi.org/10.3390/children9060902
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