Use of antimicrobials in pediatric wards of five Brazilian hospitals
Abstract The use of antimicrobials (AMs) in pediatric infections is common practice and use may be inappropriate leading to antimicrobial resistance. Off-label AM use is also common in this group and can result in drug-related problems. There is lack of DUR data in Brazil and in Latin America, speci...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-024-04655-9 |
| _version_ | 1797259013403967488 |
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| author | Thais de Barros Fernandes Sheila Feitosa Ramos Luísa Rodrigues Furtado Leitzke Ronaldo Gomes Alexandre Júnior Janaína Morais de Araújo Alcidésio Sales de Souza Júnior Alice Ramos Oliveira da Silva Isabela Heineck Marta Maria de França Fonteles Louise E. Bracken Matthew Peak Divaldo Pereira de Lyra Junior Claudia G S Osorio-de-Castro Elisangela Costa Lima |
| author_facet | Thais de Barros Fernandes Sheila Feitosa Ramos Luísa Rodrigues Furtado Leitzke Ronaldo Gomes Alexandre Júnior Janaína Morais de Araújo Alcidésio Sales de Souza Júnior Alice Ramos Oliveira da Silva Isabela Heineck Marta Maria de França Fonteles Louise E. Bracken Matthew Peak Divaldo Pereira de Lyra Junior Claudia G S Osorio-de-Castro Elisangela Costa Lima |
| author_sort | Thais de Barros Fernandes |
| collection | DOAJ |
| description | Abstract The use of antimicrobials (AMs) in pediatric infections is common practice and use may be inappropriate leading to antimicrobial resistance. Off-label AM use is also common in this group and can result in drug-related problems. There is lack of DUR data in Brazil and in Latin America, specially for AM pediatric use. The aim of this study was to describe the utilization of AMs in hospitalized children in five hospitals in Brazil. We conducted an observational study of the utilization of AMs in pediatric wards in hospitals in the states of Ceará (CE), Sergipe (SE), Rio de Janeiro (RJ), Rio Grande do Sul (RS) and the Federal District (DF). Data derived from patient medical records and prescriptions were collected over a six-month period in each hospital. The number of AMs used by each patient was recorded, and AM use was assessed using Days of therapy (DOT) and Length of therapy (LOT) per 1000 patient days according to different patient characteristics. Off-label (OL) use was described according to age. The study analyzed data from 1020 patients. The sex and age distributions were similar across the five hospitals. However, differences were found for comorbidities, history of ICU admission and length of hospital stay. The most common diseases were respiratory tract infections. There were wide variations in DOT/1000PD (278–517) and LOT/1000PD (265–390). AM utilization was highest in the hospital in SE. The consumption of second-generation penicillins and cephalosporins was high. The prevalence of OL use of AMs was higher for patients in the RJ hospital, in infants, in patients who underwent prolonged hospital stays, and in patients who used multiple AMs. The AM that showed the highest prevalence of OL use was azithromycin, in both oral and parenteral formulations. Overall AM use was high and showed differences in each setting, possibly influenced by local characteristics and by prescribing standards adopted by pediatricians. |
| first_indexed | 2024-04-24T23:02:40Z |
| format | Article |
| id | doaj.art-780208789d9d413f8da111d247c06b2c |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-24T23:02:40Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-780208789d9d413f8da111d247c06b2c2024-03-17T12:38:37ZengBMCBMC Pediatrics1471-24312024-03-012411910.1186/s12887-024-04655-9Use of antimicrobials in pediatric wards of five Brazilian hospitalsThais de Barros Fernandes0Sheila Feitosa Ramos1Luísa Rodrigues Furtado Leitzke2Ronaldo Gomes Alexandre Júnior3Janaína Morais de Araújo4Alcidésio Sales de Souza Júnior5Alice Ramos Oliveira da Silva6Isabela Heineck7Marta Maria de França Fonteles8Louise E. Bracken9Matthew Peak10Divaldo Pereira de Lyra Junior11Claudia G S Osorio-de-Castro12Elisangela Costa Lima13Sergio Arouca National School of Public Health, Oswaldo Cruz FoundationCenter for Biological and Health Sciences, Federal University of Western BahiaPostgraduate Program in Pharmaceutical Services, Faculty of Pharmacy, Federal University of Rio Grande do SulDepartment of Pharmacy, Faculty of Pharmacy, Dentistry and Nursing, Federal University of CearáAntonio Lisboa Mother and Child HospitalAntonio Lisboa Mother and Child HospitalSchool of Pharmacy, Federal University of Rio de JaneiroPostgraduate Program in Pharmaceutical Services, Faculty of Pharmacy, Federal University of Rio Grande do SulDepartment of Pharmacy, Faculty of Pharmacy, Dentistry and Nursing, Federal University of CearáPaediatric Medicines Research Unit, Institute in the Park, Alder Hey Children’s NHS Foundation TrustPaediatric Medicines Research Unit, Institute in the Park, Alder Hey Children’s NHS Foundation TrustHealth Sciences Graduate Program, Social Pharmacy Teaching and Research Laboratory (LEPFS), Federal University of SergipeSergio Arouca National School of Public Health, Oswaldo Cruz FoundationSchool of Pharmacy, Federal University of Rio de JaneiroAbstract The use of antimicrobials (AMs) in pediatric infections is common practice and use may be inappropriate leading to antimicrobial resistance. Off-label AM use is also common in this group and can result in drug-related problems. There is lack of DUR data in Brazil and in Latin America, specially for AM pediatric use. The aim of this study was to describe the utilization of AMs in hospitalized children in five hospitals in Brazil. We conducted an observational study of the utilization of AMs in pediatric wards in hospitals in the states of Ceará (CE), Sergipe (SE), Rio de Janeiro (RJ), Rio Grande do Sul (RS) and the Federal District (DF). Data derived from patient medical records and prescriptions were collected over a six-month period in each hospital. The number of AMs used by each patient was recorded, and AM use was assessed using Days of therapy (DOT) and Length of therapy (LOT) per 1000 patient days according to different patient characteristics. Off-label (OL) use was described according to age. The study analyzed data from 1020 patients. The sex and age distributions were similar across the five hospitals. However, differences were found for comorbidities, history of ICU admission and length of hospital stay. The most common diseases were respiratory tract infections. There were wide variations in DOT/1000PD (278–517) and LOT/1000PD (265–390). AM utilization was highest in the hospital in SE. The consumption of second-generation penicillins and cephalosporins was high. The prevalence of OL use of AMs was higher for patients in the RJ hospital, in infants, in patients who underwent prolonged hospital stays, and in patients who used multiple AMs. The AM that showed the highest prevalence of OL use was azithromycin, in both oral and parenteral formulations. Overall AM use was high and showed differences in each setting, possibly influenced by local characteristics and by prescribing standards adopted by pediatricians.https://doi.org/10.1186/s12887-024-04655-9Antimicrobial agentsDrug utilizationOff-label use, hospitalPediatric |
| spellingShingle | Thais de Barros Fernandes Sheila Feitosa Ramos Luísa Rodrigues Furtado Leitzke Ronaldo Gomes Alexandre Júnior Janaína Morais de Araújo Alcidésio Sales de Souza Júnior Alice Ramos Oliveira da Silva Isabela Heineck Marta Maria de França Fonteles Louise E. Bracken Matthew Peak Divaldo Pereira de Lyra Junior Claudia G S Osorio-de-Castro Elisangela Costa Lima Use of antimicrobials in pediatric wards of five Brazilian hospitals BMC Pediatrics Antimicrobial agents Drug utilization Off-label use, hospital Pediatric |
| title | Use of antimicrobials in pediatric wards of five Brazilian hospitals |
| title_full | Use of antimicrobials in pediatric wards of five Brazilian hospitals |
| title_fullStr | Use of antimicrobials in pediatric wards of five Brazilian hospitals |
| title_full_unstemmed | Use of antimicrobials in pediatric wards of five Brazilian hospitals |
| title_short | Use of antimicrobials in pediatric wards of five Brazilian hospitals |
| title_sort | use of antimicrobials in pediatric wards of five brazilian hospitals |
| topic | Antimicrobial agents Drug utilization Off-label use, hospital Pediatric |
| url | https://doi.org/10.1186/s12887-024-04655-9 |
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