Department of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Lindwurmstr. 4, 80337, Munich, Germany.
Department of Paediatric Cardiology, Saarland University Medical Center, Homburg, Germany.
Infection. 2022 Oct;50(5):1273-1279. doi: 10.1007/s15010-022-01807-w. Epub 2022 Apr 2.
Antibiotic exposure among hospitalized children is very high. With inappropriate antimicrobial use resulting in increased rates of antimicrobial resistance, the implementation of antibiotic stewardship programs is critically needed. This survey study aimed to identify current practice and knowledge about antibiotic stewardship and infection control among paediatricians in tertiary care paediatric hospitals in and around Munich, Germany.
A prospective cross-sectional study based on an anonymous questionnaire, structured into different sub-sections regarding antibiotic use, antimicrobial resistance, antibiotic stewardship and infection control, was conducted between 1st of May and 30th of June 2016 in five paediatric hospitals.
In total, 111 paediatricians across all grades were eligible for participation. The overall proportion of correct answers for all sub-sections of the survey ranged from 54.1% correct answers in the antibiotic handling and bacterial resistance section to 72.9% correct answers in the hospital hygiene/infection control section. In general, knowledge across all categories was similar for junior doctors, middle-grade doctors or consultants. Advocating empiric use of narrow-spectrum instead of broad-spectrum antibiotics was considered to be the most difficult measure to implement in daily practice (36.9%). De-escalation from broad-spectrum empirical therapy to targeted treatment was considered the easiest measure to achieve (43.2%).
Our results demonstrate that principles of antimicrobial stewardship and aspects of hospital hygiene/infection control are not satisfactorily known among hospital-based paediatricians in and around Munich. We identified four important target areas for future educational interventions that should play a more prominent role in both pre- and postgraduate medical training.
住院儿童中抗生素的使用非常高。由于不适当的抗菌药物使用导致抗菌药物耐药率增加，因此迫切需要实施抗生素管理计划。本调查研究旨在确定德国慕尼黑及其周边地区三级儿科医院的儿科医生对抗生素管理和感染控制的当前实践和知识。
2016 年 5 月 1 日至 6 月 30 日，在五家儿科医院进行了一项基于匿名问卷的前瞻性横断面研究，问卷分为抗生素使用、抗菌药物耐药性、抗生素管理和感染控制等不同部分。
共有 111 名各级儿科医生符合参与条件。调查各部分的总体正确答案比例从抗生素处理和细菌耐药性部分的 54.1%正确答案到医院卫生/感染控制部分的 72.9%正确答案不等。总的来说，所有类别医生的知识水平相似，初级医生、中级医生或顾问的知识水平相似。提倡经验性使用窄谱抗生素而不是广谱抗生素被认为是实施日常实践中最困难的措施（36.9%）。从广谱经验性治疗降级为靶向治疗被认为是最容易实现的措施（43.2%）。
我们的结果表明，抗菌药物管理原则和医院卫生/感染控制方面的知识在慕尼黑及其周边地区的医院儿科医生中并不令人满意。我们确定了四个重要的目标领域，未来的教育干预措施应在医学生和住院医师培训中发挥更重要的作用。
