Montecatine-Alonso Elena, Mejías-Trueba Marta, Goycochea-Valdivia Walter Alfredo, Chavarri-Gil Estibaliz, Fernández-Llamazares Cecilia M, Dolz Elisenda, Gutiérrez-Urbón José María, Gallego-Fernández Carmen, Llorente-Gutiérrez Jesús, Gil-Navarro María Victoria
Department of Pharmacy, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain.
Department of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/Spanish National Research Council/University Hospital Virgen del Rocio, 41013 Seville, Spain.
Antibiotics (Basel). 2023 Jan 31;12(2):276. doi: 10.3390/antibiotics12020276.
Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improve patient outcomes, and reduce resistance. To assess the effectiveness of ASPs, it is necessary to have indicators that can be widely used. Defined daily dose (DDD) was designed by WHO for the adult population as a consumption indicator. However, there are no DDDs adapted to the pediatric population. The main objective of this study is to establish the most appropriate DDD values in this population. An observational, retrospective, multicenter study was conducted. Antimicrobial prescriptions were collected from pediatric wards of seven Spanish tertiary hospitals for 2 years. The DDDs obtained from the prescriptions were compared with the theoretical DDDs agreed upon in the first stage. To select the optimal DDD, the following were analyzed: power value, magnitude obtained from the differences in the DDD, statistical significance, and degree of agreement in the stipulated doses. A total of 4788 prescriptions were collected. Pediatric DDD was defined for 30 different antimicrobials. A potency >80% was obtained in 24 antibiotics. 51.2% of the selected DDD correspond to Phase I and 39.5% from Phase II. Pediatric DDD of different antimicrobials was obtained, providing an indicator that can be used globally in different hospitals to analyze the consumption and efficacy of ASPs.
抗菌药物管理计划（ASPs）可优化抗菌药物的使用，改善患者预后，并降低耐药性。为评估抗菌药物管理计划的有效性，有必要具备可广泛应用的指标。限定日剂量（DDD）由世界卫生组织为成年人群设计，作为一种消费指标。然而，目前尚无适用于儿科人群的DDD值。本研究的主要目的是确定该人群中最合适的DDD值。开展了一项观察性、回顾性、多中心研究。收集了西班牙七家三级医院儿科病房两年内的抗菌药物处方。将从处方中获得的DDD值与第一阶段商定的理论DDD值进行比较。为选择最佳DDD，分析了以下内容：功效值、从DDD差异中获得的幅度、统计学显著性以及规定剂量的一致程度。共收集了4788份处方。为30种不同的抗菌药物定义了儿科DDD。24种抗生素的效力>80%。所选DDD的51.2%对应第一阶段，39.5%对应第二阶段。获得了不同抗菌药物的儿科DDD，提供了一种可在全球不同医院用于分析抗菌药物管理计划的使用情况和疗效的指标。
