Nitsch-Osuch Aneta, Kuchar E, Życińska K, Gyrczuk E, Miśkiewicz K, Korzeniewski K
Department of Family Medicine, Warsaw Medical University, 1A Banacha St., 02-097, Warsaw, Poland,
Adv Exp Med Biol. 2015;857:67-74. doi: 10.1007/5584_2015_124.
Hospitalized children are often treated with antibiotics. However, 30-75% of antibiotic treatment in pediatric hospitals is administrated incorrectly or unreasonably. Implementation of Hospital's Antibiotic Policy (HAP) should improve antibiotic consumption patterns in pediatric wards. The objective of this study was to determine the effectiveness of HAP by assessing antibiotic consumption in the General Pediatric Ward of an academic hospital in the city of Warsaw, Poland before and after this policy was introduced in the years 2012 and 2013, respectively. Antibiotic use was calculated in daily-defined doses (DDDs) per 100 patient-days and DDDs per 100 admissions. Antibiotics were ranked by the volume of DDDs and the number of antibiotics which accounted for 90% and 100% of the total volume: DU90% and DU100% (where DU stands for drug use). The total antibiotic consumption and significantly decreased after the implementation of HAP; DDDs were 2,177.5 before and 1,335.4 after implementation of HAP. The number of DDDs/100 patient-days was also lower; 36.3 vs. 24.9 before and after HAP, respectively. After implementation of HAP a decreased use of ceftriaxone and cefuroxime was observed. The most commonly used antibiotic was amoxicillin with clavulanic acid. The DU100% rates remained the same (8 antibiotics) and DU90% increased (from 3 in 2012 to 5 in 2013). We conclude that implementation of HAP resulted a decreased consumption of antibiotics in the General Pediatric Ward, despite the hardly changed number of children treated with antibiotics.
住院儿童经常接受抗生素治疗。然而，儿科医院中30%-75%的抗生素治疗存在用药不当或不合理的情况。实施医院抗生素政策（HAP）应能改善儿科病房的抗生素使用模式。本研究的目的是通过评估2012年和2013年分别在波兰华沙市一家学术医院的普通儿科病房引入该政策前后的抗生素使用情况，来确定HAP的有效性。抗生素使用量以每100个患者日的限定日剂量（DDD）和每100次入院的DDD来计算。抗生素按DDD量进行排序，并统计占总量90%和100%的抗生素数量：DU90%和DU100%（其中DU代表药物使用）。实施HAP后，抗生素总消耗量显著下降；实施HAP前DDD为2177.5，实施后为1335.4。每100个患者日的DDD数也更低；HAP实施前后分别为36.3和24.9。实施HAP后，观察到头孢曲松和头孢呋辛的使用量减少。最常用的抗生素是阿莫西林克拉维酸。DU100%的比率保持不变（8种抗生素），而DU90%增加（从2012年的3种增加到2013年的5种）。我们得出结论，尽管接受抗生素治疗的儿童数量几乎没有变化，但实施HAP导致普通儿科病房的抗生素消耗量下降。
