Raastad Ragnhild, Tvete Ingunn Fride, Abrahamsen Tore G, Berild Dag, Leegaard Truls M, Walberg Mette, Müller Fredrik
Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Paediatr. 2015 Jul;104(7):687-92. doi: 10.1111/apa.12994. Epub 2015 Apr 1.
The World Health Organization recommends the defined daily dose (DDD) as the standard unit of measurement for antibiotic use, but this is not applicable in children. We aimed to assess paediatric antibiotic use in a Norwegian tertiary care hospital using a novel weight-adjusted method.
We obtained antibiotic purchase data from the hospital pharmacy and administrative data for all admissions from 2002 to 2009 to the paediatric wards at Oslo University Hospital, Rikshospitalet. Recommended daily doses per 100 kg days (RDDs/kg days) were calculated based on national guidelines for paediatric antibiotic use, length of stay and estimated weight for sex and age using national growth references.
Total antibiotic use increased significantly from 51.8 to 65.5 RDDs/100 kg days. We found statistically significant annual increases in the consumption of carbapenems (18.0%), third-generation cephalosporins (6.0%) and imidazole derivatives (6.6%) and a considerable difference between total antibiotic use measured in RDDs/100 kg days and DDDs/100 bed days for neonates.
Weight-adjusted antibiotic use provided a more meaningful description of the quantities of antibiotics consumed than DDDs/100 bed days, particularly for neonates. Total antibiotic use, use of meropenem, third-generation cephalosporins and imidazole derivatives increased significantly despite low prevalence of antibiotic-resistant pathogens.
世界卫生组织推荐限定日剂量（DDD）作为抗生素使用的标准计量单位，但这不适用于儿童。我们旨在使用一种新的体重调整方法评估挪威一家三级护理医院的儿科抗生素使用情况。
我们从医院药房获取了抗生素采购数据，并获取了2002年至2009年奥斯陆大学医院里司医院儿科病房所有住院患者的管理数据。根据国家儿科抗生素使用指南、住院时间以及使用国家生长参考数据按性别和年龄估算的体重，计算每100千克日的推荐日剂量（RDDs/kg日）。
抗生素总使用量从51.8 RDDs/100千克日显著增加至65.5 RDDs/100千克日。我们发现碳青霉烯类（18.0%）、第三代头孢菌素（6.0%）和咪唑衍生物（6.6%）的消耗量有统计学意义的年度增长，并且在以RDDs/100千克日和DDDs/100床日衡量的新生儿抗生素总使用量之间存在相当大的差异。
与DDDs/100床日相比，体重调整后的抗生素使用量能更有意义地描述抗生素的消耗量，尤其是对于新生儿。尽管抗生素耐药病原体的流行率较低，但抗生素总使用量、美罗培南、第三代头孢菌素和咪唑衍生物的使用量仍显著增加。
