Ergül Ayşe Betül, Gökçek İkbal, Çelik Taylan, Torun Yasemin Altuner
Health Sciences University, Kayseri Education and Research Hospital, Pediatrics Clinic, Kayseri, Turkey.
Health Sciences University, Kayseri Education and Research Hospital, Division of Pediatric Infectious Diseases, Kayseri, Turkey.
Turk Pediatri Ars. 2018 Mar 1;53(1):17-23. doi: 10.5152/TurkPediatriArs.2018.5644. eCollection 2018 Mar.
This study aimed to determine inappropriate antibiotic use in a children's hospital using the point-surveillance method.
One hundred thirteen hospitalized patients were included in the study on the study day. In all patients, data regarding age, sex, antibiotic use, type and dose of antibiotic if used, multiple antibiotic use, presence or absence of consultation with infectious diseases specialist before initiation of antibiotic, form of antibiotic use (empiric, targeted or prophylactic), and reason for antibiotic use were recorded. Inappropriate antibiotic use was determined by an infectious diseases specialist.
The rate of antibiotic use was 70.8%. Of the patients receiving antibiotics, 43% were using more than one antibiotic. It was found that 73.7% of antibiotics were prescribed for empiric purposes and 14.3% for targeted therapy, whereas 12% were prescribed for prophylactic purposes. The rate of inappropriate antibiotic use was 33.8% among patients who were given antibiotics. Unnecessary antibiotic prescription was the most common cause for inappropriate antibiotic use (51.9%), followed by unnecessary multiple antibiotic use (29.6%), inaccurate dosing (11.1%), use of broader spectrum than required (7.4%), and use of antibiotics with narrower spectrum than needed (3.7%). The rate of inappropriate antibiotic use was significantly lower in antibiotics that required confirmation by an infectious diseases specialist (6.7%) than those not requiring confirmation (26.3%; p=0.023). The rate of inappropriate antibiotic use was significantly lower in antibiotics prescribed by infectious diseases specialists (8.6%) than those prescribed by other physicians (26.5%, p=0.027).
Antibiotic use based on consultation with an infectious diseases specialist decreased inappropriate antibiotic use.
本研究旨在采用现患率调查方法确定一家儿童医院中不恰当的抗生素使用情况。
在研究日,113名住院患者被纳入研究。记录了所有患者的年龄、性别、抗生素使用情况、若使用抗生素则记录其类型和剂量、联合使用多种抗生素情况、开始使用抗生素前是否咨询感染病专科医生、抗生素使用形式(经验性、针对性或预防性)以及使用抗生素的原因。不恰当的抗生素使用由感染病专科医生判定。
抗生素使用率为70.8%。在接受抗生素治疗的患者中,43%使用了不止一种抗生素。发现73.7%的抗生素是经验性使用,14.3%是针对性治疗使用,而12%是预防性使用。在接受抗生素治疗的患者中,不恰当抗生素使用率为33.8%。不必要的抗生素处方是不恰当抗生素使用的最常见原因(51.9%),其次是不必要的联合使用多种抗生素(29.6%)、剂量不准确(11.1%)、使用了比所需更广谱的抗生素(7.4%)以及使用了比所需更窄谱的抗生素(3.7%)。需要感染病专科医生确认的抗生素的不恰当使用率(6.7%)显著低于不需要确认的抗生素(26.3%;p=0.023)。感染病专科医生开具的抗生素的不恰当使用率(8.6%)显著低于其他医生开具的抗生素(26.5%,p=0.027)。
基于咨询感染病专科医生的抗生素使用减少了不恰当的抗生素使用。