Rachina Svetlana, Belkova Yuliya, Kozlov Roman, Mladov Vladimir, Mishchenko Vladimir, Andreeva Alla, Domanskaya Olga, Portnjagina Ulyana, Dushina Anastasiia, Zainalabidova Khadizhat
Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia.
Department of Clinical Pharmacology, Smolensk State Medical University, 214019 Smolensk, Russia.
Antibiotics (Basel). 2023 Jul 7;12(7):1162. doi: 10.3390/antibiotics12071162.
the objective of this study was to propose a methodology for the assessment of antimicrobial consumption (AMC) in pediatric inpatients and to estimate variances in consumption levels in multi-field hospitals with pediatric inpatients, calculated by means of the pediatric-adjusted methodology vs. the conventional methodology.
the pediatric-adjusted methodology based on the conventional ATC/DDD method and children's DDDs (cDDD) for antimicrobials were proposed and validated in a series of probabilistic sensitivity analyses of real clinical data extracted from the receipt notes of three multi-field hospitals. Differences in AMC in multi-field hospitals with pediatric inpatients, calculated by means of the proposed methodology vs. the conventional methodology, were assessed for a virtual cohort of inpatients, with the pediatric share increasing by 1%.
in children ≤12 years old, assessment by the standard methodology resulted in a 59% underestimation of AMC from the levels based on prescribed doses, vs. a 25% underestimation for the proposed methodology. In a mixed-age virtual population of inpatients, the underestimation of consumption levels rose to 321% for the ATC/DDD methodology compared to the proposed one.
the proposed methodology demonstrated a higher accuracy of AMC estimates compared to the conventional one and can be considered for the quantification of antimicrobial utilization in pediatric institutions and multi-field hospitals with a substantial share of pediatric inpatients.
本研究的目的是提出一种评估儿科住院患者抗菌药物消耗量（AMC）的方法，并通过儿科调整方法与传统方法来估计有儿科住院患者的多科室医院中消耗量水平的差异。
基于传统的解剖学治疗学化学分类系统/限定日剂量（ATC/DDD）方法和抗菌药物的儿童限定日剂量（cDDD），提出了儿科调整方法，并在从三家多科室医院的收据中提取的真实临床数据的一系列概率敏感性分析中进行了验证。对于一个虚拟住院患者队列，评估了采用所提出的方法与传统方法计算的有儿科住院患者的多科室医院中AMC的差异，儿科患者比例增加1%。
在≤12岁的儿童中，标准方法评估得出的AMC比基于规定剂量得出的水平低59%，而所提出的方法低估了25%。在混合年龄的虚拟住院患者人群中，与所提出的方法相比，ATC/DDD方法对消耗量水平的低估上升至321%。
与传统方法相比，所提出的方法在AMC估计方面显示出更高的准确性，可用于量化儿科机构以及有大量儿科住院患者的多科室医院中的抗菌药物使用情况。
