Papan Cihan, Reifenrath Katharina, Last Katharina, Attarbaschi Andishe, Graf Norbert, Groll Andreas H, Huebner Johannes, Laws Hans-Jürgen, Lehrnbecher Thomas, Liese Johannes, Martin Luise, Tenenbaum Tobias, Weichert Stefan, Vieth Simon, von Both Ulrich, Hufnagel Markus, Simon Arne
Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
Pediatric Hematology and Oncology, University Children's Hospital, Saarland University, Homburg, Germany.
JMIR Res Protoc. 2022 Jun 20;11(6):e35774. doi: 10.2196/35774.
Because infections are a major driver of morbidity and mortality in children with hematologic or oncologic diseases, antimicrobials are frequently prescribed in pediatric oncology practice. However, excess or inappropriate use of antimicrobials is directly linked to the emergence of antimicrobial resistance. Although point-prevalence studies have examined the extent of antimicrobial use, a comprehensive qualitative evaluation of individual antimicrobial prescriptions remains lacking.
The aim of this study is to identify appropriate versus inappropriate antimicrobial use among pediatric cancer patients in a point-prevalence study, followed by an expert panel adjudication process and a subsequent report of these findings to participating centers. This study also aims to improve the quality of patient care by informing centers about discrepancies between internal standards of care and national guidelines.
Our point-prevalence study is performed at pediatric cancer centers in Germany and Austria. All patients under 18 years old who are hospitalized at the time of the study are included. As a supplement to the point-prevalence study, an expert panel is qualitatively assessing each of the antimicrobial prescriptions at the participating centers to review local guidelines and compare them with national guidelines.
As of December 2021, the point-prevalence survey has been conducted at 30 sites and expert panel adjudication for qualitative assessment of each antimicrobial use is ongoing. Results of the study are expected in 2022.
This is the first point-prevalence study conducted among pediatric cancer centers with an integrated, multistep, qualitative approach that assesses each antimicrobial prescription. The results of this study will inform possible interventions for internal guidelines and antimicrobial stewardship programs implemented at pediatric cancer centers. In addition, local guidelines will be compared with national guidelines. Furthermore, this study will contribute to the overall integration of antimicrobial stewardship principles and initiatives in pediatric oncology and hematology, thereby improving safety and quality of care for children and adolescents with cancer and blood disorders.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35774.
由于感染是血液系统或肿瘤性疾病患儿发病和死亡的主要驱动因素，抗菌药物在儿科肿瘤实践中经常被使用。然而，抗菌药物的过度或不当使用与抗菌药物耐药性的出现直接相关。尽管现患率研究已经考察了抗菌药物的使用程度，但仍缺乏对个体抗菌药物处方的全面定性评估。
本研究的目的是在一项现患率研究中确定儿科癌症患者中抗菌药物使用恰当与不恰当的情况，随后进行专家小组裁决，并将这些结果报告给参与研究的中心。本研究还旨在通过向各中心通报内部护理标准与国家指南之间的差异来提高患者护理质量。
我们的现患率研究在德国和奥地利的儿科癌症中心进行。纳入所有在研究时住院的18岁以下患者。作为现患率研究的补充，一个专家小组正在对参与研究中心的每一份抗菌药物处方进行定性评估，以审查当地指南并将其与国家指南进行比较。
截至2021年12月，已在30个地点进行了现患率调查，对每种抗菌药物使用情况进行定性评估的专家小组裁决正在进行中。预计2022年得出研究结果。
这是首次在儿科癌症中心开展的现患率研究，采用综合、多步骤的定性方法评估每份抗菌药物处方。本研究结果将为儿科癌症中心实施的内部指南和抗菌药物管理计划的可能干预措施提供依据。此外，将当地指南与国家指南进行比较。此外，本研究将有助于抗菌药物管理原则和举措在儿科肿瘤学和血液学中的全面整合，从而提高癌症和血液疾病儿童及青少年的护理安全性和质量。
国际注册报告识别码（IRRID）：DERR1-10.2196/35774
