Laine Niina, Hoppu Kalle, Airaksinen Marja, Saxen Harri
Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
Eur J Hosp Pharm. 2016 Sep;23(5):266-271. doi: 10.1136/ejhpharm-2015-000766. Epub 2016 Feb 11.
Numbers of resistant pathogens are constantly increasing, and prudent use of antimicrobials is of paramount importance. In order to see whether any changes in the use of antimicrobials in recent years have occurred, we decided to monitor the consumption of these drugs at a single tertiary paediatric hospital.
This single-centre retrospective study investigated the consumption of antimicrobials in defined daily doses (DDDs according to the Anatomical Therapeutical Chemical /DDD index) in a 130-bed paediatric tertiary hospital. The data on the consumption of antimicrobials were collected from years 2003-2013 by using electronic surveillance records provided by the local pharmacy. The consumption was related to days of hospital care.
During 2003-2013, the use of penicillins, cephalosporins and carbapenems increased by 28%, 46% and 110%, respectively. The consumption of both aminoglycosides and vancomycin decreased by 61% and 41%, respectively. Amphotericin B use clearly decreased by 39% while the use of novel azoles and echinocandins increased.
Increased use of carbapenems was the most significant finding of our study. The year-to-year consumption of antibacterials was in general relatively stable and new antibacterials were taken into use conservatively. In contrast to antibacterials, novel antifungals were rapidly adopted into use despite scarce evidence on their safety in children.
耐药病原体数量不断增加，谨慎使用抗菌药物至关重要。为了解近年来抗菌药物使用情况是否发生变化，我们决定在一家三级儿科医院监测这些药物的消耗情况。
这项单中心回顾性研究调查了一家拥有130张床位的儿科三级医院按限定日剂量（根据解剖学治疗学化学分类/限定日剂量索引）计算的抗菌药物消耗情况。抗菌药物消耗数据通过当地药房提供的电子监测记录收集，时间跨度为2003年至2013年。消耗情况与住院天数相关。
在2003年至2013年期间，青霉素、头孢菌素和碳青霉烯类药物的使用量分别增加了28%、46%和110%。氨基糖苷类药物和万古霉素的消耗量分别下降了61%和41%。两性霉素B的使用量明显下降了39%，而新型唑类药物和棘白菌素的使用量增加。
碳青霉烯类药物使用量增加是我们研究中最显著的发现。抗菌药物的年度消耗量总体相对稳定，新抗菌药物的使用较为保守。与抗菌药物不同，尽管缺乏儿童安全性方面的证据，但新型抗真菌药物仍迅速被采用。
