Materno-Infantil Departament, Faculdade de Medicina, Universidade Federal Fluminense, Rua Marquês do Paraná 303, Niterói, RJ, 24033-900, Brazil.
Infectiology Service, Dr. von Hauner Children's Hospital, LMU Munich, 80337, Munich, Germany.
Eur J Clin Microbiol Infect Dis. 2020 Feb;39(2):249-255. doi: 10.1007/s10096-019-03714-9. Epub 2019 Oct 31.
Antibiotic consumption (AC) is a key component of antimicrobial stewardship programs to recognize local patterns of antibiotic use. Our aim was to measure AC in neonatal units, including neonatal (NICU)/paediatric (PICU) intensive care units in different countries. We conducted a multicenter, retrospective, cohort study in three NICUs, one neonatal ward, and three PICUs with a total of 84 beds. Global and individual AC in days of therapy (DOT) and DOT per 1000 patient-days were assessed. During the study period, 2567 patients were admitted, corresponding to 4961 patient-days in neonatal units and 9243 patient-days in PICUs. Multidrug-resistant Gram-negative bacteria and methicillin-resistant Staphylococcus aureus were more frequent in Brazil than in Germany. Average AC was 386.5 and 1335.5 DOT/1000PD in German and Brazilian neonatal units, respectively. Aminopenicillins plus 3rd generation cephalosporins were the most commonly prescribed antibiotics in German neonatal units, while aminopenicillins plus aminoglycosides were the class most commonly used in Brazilian NICU. Average AC was 888.1 and 1440.7 DOT/1000PD in German and Brazilian PICUs, respectively. Antipseudomonal penicillins were most commonly used in the German PICU, and glycopeptides were the most frequently prescribed in Brazilian PICUs. Carbapenems represented 2.3-14% of total DOTs in German neonatal units and 4% in the Brazilian NICU and 13.0% in the German PICU and 6-12.2% in Brazilian PICUs. We concluded that different patterns of most commonly prescribed antibiotics were observed in neonatal units and PICUs in these two countries, probably related to different local patterns of antibiotic resistance, with a higher antibiotic consumption in Brazilian study units.
抗生素使用量（AC）是抗菌药物管理计划的一个关键组成部分，旨在识别当地的抗生素使用模式。我们的目的是测量不同国家新生儿病房（NICU）/儿科重症监护病房（PICU）的抗生素使用量。我们在三个 NICU、一个新生儿病房和三个 PICU 中进行了一项多中心、回顾性、队列研究，共有 84 张床位。评估了全球和个体抗生素使用日（DOT）和每 1000 患者日的 DOT。在研究期间，共收治 2567 名患者，新生儿病房和 PICU 分别为 4961 名和 9243 名患者日。耐多药革兰氏阴性菌和耐甲氧西林金黄色葡萄球菌在巴西比在德国更为常见。德国新生儿病房的平均 AC 为 386.5 和 1335.5 DOT/1000PD，巴西新生儿病房的平均 AC 为 386.5 和 1335.5 DOT/1000PD。德国新生儿病房最常开的抗生素是氨芐西林加第三代头孢菌素，而巴西 NICU 最常开的抗生素是氨芐西林加氨基糖苷类。德国 PICU 最常开的抗生素是抗假单胞青霉素，而巴西 PICU 最常开的抗生素是糖肽类。在德国新生儿病房，碳青霉烯类药物占总抗生素使用量的 2.3-14%，在巴西 NICU 占 4%，在德国 PICU 占 13.0%，在巴西 PICU 占 6-12.2%。我们的结论是，这两个国家的新生儿病房和 PICU 使用的最常用抗生素模式不同，这可能与不同的局部抗生素耐药模式有关，巴西研究单位的抗生素使用量更高。
