Comparing neonatal and paediatric antibiotic prescribing between hospitals: A new algorithm to help international benchmarking

Alessandro Porta, Yingfen Hsia, Katja Doerholt, Nikos Spyridis, Julia Bielicki, Esse Menson, Maria Tsolia, Susanna Esposito, Ian C K Wong, Mike Sharland

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: The WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology is a standardized method of comparing antimicrobial use. The ATC/DDD is defined as the average maintenance daily dose of a drug used in a 70 kg adult, ignoring the considerable differences in body weight of neonates and children. The aim of this study was to develop a new standardized way of comparing rates of antimicrobial prescribing between European children's hospitals. Methods: This pilot study at four European children's hospitals (in the UK, Greece and Italy) collected data including demographics, antibiotic use, dosing and indication in children and neonates over a 14 day period. Results: A total of 1217 antibiotic prescriptions were issued with 47 different antibiotics used. Approximately half of all children and a third of all neonates received antibiotics, with wide variation between centres in the type and dose of antibiotic used. We propose a new pragmatic three-step algorithm. The first step includes a simple comparison of the proportion of hospitalized children on antibiotics by weight bands and the number of antimicrobials that account for 90% of total DDD drug usage (DU90%). The second step is a comparison of the dosing used (mg/kg/day). The third step is to compare overall drug exposure using DDD/100 bed days for standardized weight bands between centres. Conclusions: This novel method has the potential to be a useful tool to provide antibiotic use comparator data and requires validation in a large prospective point prevalence study.

Original languageEnglish
Article numberdks021
Pages (from-to)1278-1286
Number of pages9
JournalJournal of Antimicrobial Chemotherapy
Volume67
Issue number5
DOIs
Publication statusPublished - May 2012

Fingerprint

Benchmarking
Pediatrics
Anti-Bacterial Agents
Newborn Infant
Pharmaceutical Preparations
Weights and Measures
Hospitalized Child
Greece
Italy
Prescriptions
Cross-Sectional Studies
Body Weight
Maintenance
Demography
Therapeutics

Keywords

  • Antimicrobials
  • Defined daily dose
  • Neonates

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Porta, A., Hsia, Y., Doerholt, K., Spyridis, N., Bielicki, J., Menson, E., ... Sharland, M. (2012). Comparing neonatal and paediatric antibiotic prescribing between hospitals: A new algorithm to help international benchmarking. Journal of Antimicrobial Chemotherapy, 67(5), 1278-1286. [dks021]. https://doi.org/10.1093/jac/dks021

Comparing neonatal and paediatric antibiotic prescribing between hospitals : A new algorithm to help international benchmarking. / Porta, Alessandro; Hsia, Yingfen; Doerholt, Katja; Spyridis, Nikos; Bielicki, Julia; Menson, Esse; Tsolia, Maria; Esposito, Susanna; Wong, Ian C K; Sharland, Mike.

In: Journal of Antimicrobial Chemotherapy, Vol. 67, No. 5, dks021, 05.2012, p. 1278-1286.

Research output: Contribution to journalArticle

Porta, A, Hsia, Y, Doerholt, K, Spyridis, N, Bielicki, J, Menson, E, Tsolia, M, Esposito, S, Wong, ICK & Sharland, M 2012, 'Comparing neonatal and paediatric antibiotic prescribing between hospitals: A new algorithm to help international benchmarking', Journal of Antimicrobial Chemotherapy, vol. 67, no. 5, dks021, pp. 1278-1286. https://doi.org/10.1093/jac/dks021
Porta, Alessandro ; Hsia, Yingfen ; Doerholt, Katja ; Spyridis, Nikos ; Bielicki, Julia ; Menson, Esse ; Tsolia, Maria ; Esposito, Susanna ; Wong, Ian C K ; Sharland, Mike. / Comparing neonatal and paediatric antibiotic prescribing between hospitals : A new algorithm to help international benchmarking. In: Journal of Antimicrobial Chemotherapy. 2012 ; Vol. 67, No. 5. pp. 1278-1286.
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