The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children

A. Versporten, Julia Bielicki, N. Drapier, Mike Sharland, Hermanon Goossens, Graciela Maria Calle, Julia Clark, Celia Cooper, Christopher C. Blyth, Joshua Reginald Francis, Jameela Alsalman, H. Jansens, L. Mahieu, Paul Van Rossom, Wouter Vandewal, Philippe Lepage, Sophie Blumental, C. Briquet, Dirk Robbrecht, Pierre MatonP. Gabriels, Zana Rubic, Tanja Kovacevic, Jens Peter Nielsen, Jes Reinholdt Petersen, Porntiva Poorisrisak, L. Jensen, Mari Laan, E. Tamm, Maire Matsinen, M. Rummukainen, Vincent Gajdos, Romain Olivier, Flore Le Maréchal, Alain Martinot, S. Prot-Labarthe, Mathie Lorrot, Daniel Orbach, K. Pagava, M. Hufnagel, Markus Knuf, Stephanie A A Schlag, J. G. Liese, Lorna Renner, Anthony Enimil, Marah Awunyo, G. Syridou, Nikos Spyridis, Elena Critselis, Sofia Kouni, K. Mougkou, Fani Ladomenou, D. Gkentzi, E. Iosifidis, E. Roilides, Suneeta Sahu, Srinivas Murki, Manoj Malviya, Durga Bhavani Kalavalapalli, Sanjeev Singh, Tanu Singhal, Garima Garg, Pankaj Garg, Neelam Kler, Jafar Soltani, Zahra Jafarpour, Gholamreza Pouladfar, G. Nicolini, Carlotta Montagnani, Luisa Galli, Susanna Esposito, Andrea Lo Vecchio, Daniele Dona', Carlo Giaquinto, Eleonora Borgia, Patrizia D'Argenio, M. De Luca, Chiara Centenari, Lul Raka, Abeer Omar, Haifaa Al Mousa, Dzintars Mozgis, Inese Sviestina, Sigita Burokiene, Vytautas Usonis, G. Tavchioska, Antonia Hargadon-Lowe, Peter Zarb, M. Borg, Carlos Agustín González Lozano, Patricia Zárate Castañon, Martha E. Cancino, B. McCullagh, A. McCorry, Cairine Gormley, Zaina Al Maskari, Amina Al-Jardani, Magdalena Pluta, Fernanda Rodrigues, A. Brett, I. Esteves, Laura Marques, Jameela Ali AlAjmi, S. C. Cambrea, Asia N. Rashed, Aeshah Abdu Mubarak Al Azmi, Si Min Chan, Mas Suhaila Isa, Peter Najdenov, M. Cizman, S. Unuk, Heather Finlayson, Angela Dramowski, Irene Maté-Cano, Beatriz Soto, Cristina Calvo, B. Santiago, Jesus Saavedra-Lozano, A. Bustinza, Luis Escosa-García, N. Ureta, Alfredo Tagarro, Pedro Terol Barrero, Elena Maria Rincon-Lopez, Ismaela Abubakar, J. Aston, Maggie Heginbothom, P. Satodia, Mehdi Garbash, Alison Johnson, D. Sharpe, Christopher Barton, Esse Menson, Sara Arenas-Lopez, Suzanne Luck, Katja Doerholt, Paddy McMaster, N. Caldwell, Andrew Lunn, S. Drysdale, Rachel Howe, Tim Scorrer, Florian Gahleitner, Richa Gupta, C. Nash, John Alexander, Mala Raman, Emily Bell, Veena Rajagopal, Stephan Kohlhoff, Elaine Cox, Theoklis Zaoutis

Research output: Contribution to journalArticle

Abstract

Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children.

Original languageEnglish
Article numberdkv418
Pages (from-to)1106-1117
Number of pages12
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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Latin America
Microbial Drug Resistance
Anti-Bacterial Agents
Hospitalized Child
Newborn Infant
Inpatients
meropenem
North America
Benchmarking
Eastern Europe
Ceftriaxone
Cross Infection
Quality Improvement
Surveys and Questionnaires
Documentation

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey : Developing hospital-quality indicators of antibiotic prescribing for children. / Versporten, A.; Bielicki, Julia; Drapier, N.; Sharland, Mike; Goossens, Hermanon; Calle, Graciela Maria; Clark, Julia; Cooper, Celia; Blyth, Christopher C.; Francis, Joshua Reginald; Alsalman, Jameela; Jansens, H.; Mahieu, L.; Van Rossom, Paul; Vandewal, Wouter; Lepage, Philippe; Blumental, Sophie; Briquet, C.; Robbrecht, Dirk; Maton, Pierre; Gabriels, P.; Rubic, Zana; Kovacevic, Tanja; Nielsen, Jens Peter; Petersen, Jes Reinholdt; Poorisrisak, Porntiva; Jensen, L.; Laan, Mari; Tamm, E.; Matsinen, Maire; Rummukainen, M.; Gajdos, Vincent; Olivier, Romain; Le Maréchal, Flore; Martinot, Alain; Prot-Labarthe, S.; Lorrot, Mathie; Orbach, Daniel; Pagava, K.; Hufnagel, M.; Knuf, Markus; Schlag, Stephanie A A; Liese, J. G.; Renner, Lorna; Enimil, Anthony; Awunyo, Marah; Syridou, G.; Spyridis, Nikos; Critselis, Elena; Kouni, Sofia; Mougkou, K.; Ladomenou, Fani; Gkentzi, D.; Iosifidis, E.; Roilides, E.; Sahu, Suneeta; Murki, Srinivas; Malviya, Manoj; Kalavalapalli, Durga Bhavani; Singh, Sanjeev; Singhal, Tanu; Garg, Garima; Garg, Pankaj; Kler, Neelam; Soltani, Jafar; Jafarpour, Zahra; Pouladfar, Gholamreza; Nicolini, G.; Montagnani, Carlotta; Galli, Luisa; Esposito, Susanna; Vecchio, Andrea Lo; Dona', Daniele; Giaquinto, Carlo; Borgia, Eleonora; D'Argenio, Patrizia; De Luca, M.; Centenari, Chiara; Raka, Lul; Omar, Abeer; Al Mousa, Haifaa; Mozgis, Dzintars; Sviestina, Inese; Burokiene, Sigita; Usonis, Vytautas; Tavchioska, G.; Hargadon-Lowe, Antonia; Zarb, Peter; Borg, M.; González Lozano, Carlos Agustín; Castañon, Patricia Zárate; Cancino, Martha E.; McCullagh, B.; McCorry, A.; Gormley, Cairine; Al Maskari, Zaina; Al-Jardani, Amina; Pluta, Magdalena; Rodrigues, Fernanda; Brett, A.; Esteves, I.; Marques, Laura; AlAjmi, Jameela Ali; Cambrea, S. C.; Rashed, Asia N.; Al Azmi, Aeshah Abdu Mubarak; Chan, Si Min; Isa, Mas Suhaila; Najdenov, Peter; Cizman, M.; Unuk, S.; Finlayson, Heather; Dramowski, Angela; Maté-Cano, Irene; Soto, Beatriz; Calvo, Cristina; Santiago, B.; Saavedra-Lozano, Jesus; Bustinza, A.; Escosa-García, Luis; Ureta, N.; Tagarro, Alfredo; Barrero, Pedro Terol; Rincon-Lopez, Elena Maria; Abubakar, Ismaela; Aston, J.; Heginbothom, Maggie; Satodia, P.; Garbash, Mehdi; Johnson, Alison; Sharpe, D.; Barton, Christopher; Menson, Esse; Arenas-Lopez, Sara; Luck, Suzanne; Doerholt, Katja; McMaster, Paddy; Caldwell, N.; Lunn, Andrew; Drysdale, S.; Howe, Rachel; Scorrer, Tim; Gahleitner, Florian; Gupta, Richa; Nash, C.; Alexander, John; Raman, Mala; Bell, Emily; Rajagopal, Veena; Kohlhoff, Stephan; Cox, Elaine; Zaoutis, Theoklis.

In: Journal of Antimicrobial Chemotherapy, Vol. 71, No. 4, dkv418, 01.04.2016, p. 1106-1117.

Research output: Contribution to journalArticle

Versporten, A, Bielicki, J, Drapier, N, Sharland, M, Goossens, H, Calle, GM, Clark, J, Cooper, C, Blyth, CC, Francis, JR, Alsalman, J, Jansens, H, Mahieu, L, Van Rossom, P, Vandewal, W, Lepage, P, Blumental, S, Briquet, C, Robbrecht, D, Maton, P, Gabriels, P, Rubic, Z, Kovacevic, T, Nielsen, JP, Petersen, JR, Poorisrisak, P, Jensen, L, Laan, M, Tamm, E, Matsinen, M, Rummukainen, M, Gajdos, V, Olivier, R, Le Maréchal, F, Martinot, A, Prot-Labarthe, S, Lorrot, M, Orbach, D, Pagava, K, Hufnagel, M, Knuf, M, Schlag, SAA, Liese, JG, Renner, L, Enimil, A, Awunyo, M, Syridou, G, Spyridis, N, Critselis, E, Kouni, S, Mougkou, K, Ladomenou, F, Gkentzi, D, Iosifidis, E, Roilides, E, Sahu, S, Murki, S, Malviya, M, Kalavalapalli, DB, Singh, S, Singhal, T, Garg, G, Garg, P, Kler, N, Soltani, J, Jafarpour, Z, Pouladfar, G, Nicolini, G, Montagnani, C, Galli, L, Esposito, S, Vecchio, AL, Dona', D, Giaquinto, C, Borgia, E, D'Argenio, P, De Luca, M, Centenari, C, Raka, L, Omar, A, Al Mousa, H, Mozgis, D, Sviestina, I, Burokiene, S, Usonis, V, Tavchioska, G, Hargadon-Lowe, A, Zarb, P, Borg, M, González Lozano, CA, Castañon, PZ, Cancino, ME, McCullagh, B, McCorry, A, Gormley, C, Al Maskari, Z, Al-Jardani, A, Pluta, M, Rodrigues, F, Brett, A, Esteves, I, Marques, L, AlAjmi, JA, Cambrea, SC, Rashed, AN, Al Azmi, AAM, Chan, SM, Isa, MS, Najdenov, P, Cizman, M, Unuk, S, Finlayson, H, Dramowski, A, Maté-Cano, I, Soto, B, Calvo, C, Santiago, B, Saavedra-Lozano, J, Bustinza, A, Escosa-García, L, Ureta, N, Tagarro, A, Barrero, PT, Rincon-Lopez, EM, Abubakar, I, Aston, J, Heginbothom, M, Satodia, P, Garbash, M, Johnson, A, Sharpe, D, Barton, C, Menson, E, Arenas-Lopez, S, Luck, S, Doerholt, K, McMaster, P, Caldwell, N, Lunn, A, Drysdale, S, Howe, R, Scorrer, T, Gahleitner, F, Gupta, R, Nash, C, Alexander, J, Raman, M, Bell, E, Rajagopal, V, Kohlhoff, S, Cox, E & Zaoutis, T 2016, 'The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children', Journal of Antimicrobial Chemotherapy, vol. 71, no. 4, dkv418, pp. 1106-1117. https://doi.org/10.1093/jac/dkv418
Versporten, A. ; Bielicki, Julia ; Drapier, N. ; Sharland, Mike ; Goossens, Hermanon ; Calle, Graciela Maria ; Clark, Julia ; Cooper, Celia ; Blyth, Christopher C. ; Francis, Joshua Reginald ; Alsalman, Jameela ; Jansens, H. ; Mahieu, L. ; Van Rossom, Paul ; Vandewal, Wouter ; Lepage, Philippe ; Blumental, Sophie ; Briquet, C. ; Robbrecht, Dirk ; Maton, Pierre ; Gabriels, P. ; Rubic, Zana ; Kovacevic, Tanja ; Nielsen, Jens Peter ; Petersen, Jes Reinholdt ; Poorisrisak, Porntiva ; Jensen, L. ; Laan, Mari ; Tamm, E. ; Matsinen, Maire ; Rummukainen, M. ; Gajdos, Vincent ; Olivier, Romain ; Le Maréchal, Flore ; Martinot, Alain ; Prot-Labarthe, S. ; Lorrot, Mathie ; Orbach, Daniel ; Pagava, K. ; Hufnagel, M. ; Knuf, Markus ; Schlag, Stephanie A A ; Liese, J. G. ; Renner, Lorna ; Enimil, Anthony ; Awunyo, Marah ; Syridou, G. ; Spyridis, Nikos ; Critselis, Elena ; Kouni, Sofia ; Mougkou, K. ; Ladomenou, Fani ; Gkentzi, D. ; Iosifidis, E. ; Roilides, E. ; Sahu, Suneeta ; Murki, Srinivas ; Malviya, Manoj ; Kalavalapalli, Durga Bhavani ; Singh, Sanjeev ; Singhal, Tanu ; Garg, Garima ; Garg, Pankaj ; Kler, Neelam ; Soltani, Jafar ; Jafarpour, Zahra ; Pouladfar, Gholamreza ; Nicolini, G. ; Montagnani, Carlotta ; Galli, Luisa ; Esposito, Susanna ; Vecchio, Andrea Lo ; Dona', Daniele ; Giaquinto, Carlo ; Borgia, Eleonora ; D'Argenio, Patrizia ; De Luca, M. ; Centenari, Chiara ; Raka, Lul ; Omar, Abeer ; Al Mousa, Haifaa ; Mozgis, Dzintars ; Sviestina, Inese ; Burokiene, Sigita ; Usonis, Vytautas ; Tavchioska, G. ; Hargadon-Lowe, Antonia ; Zarb, Peter ; Borg, M. ; González Lozano, Carlos Agustín ; Castañon, Patricia Zárate ; Cancino, Martha E. ; McCullagh, B. ; McCorry, A. ; Gormley, Cairine ; Al Maskari, Zaina ; Al-Jardani, Amina ; Pluta, Magdalena ; Rodrigues, Fernanda ; Brett, A. ; Esteves, I. ; Marques, Laura ; AlAjmi, Jameela Ali ; Cambrea, S. C. ; Rashed, Asia N. ; Al Azmi, Aeshah Abdu Mubarak ; Chan, Si Min ; Isa, Mas Suhaila ; Najdenov, Peter ; Cizman, M. ; Unuk, S. ; Finlayson, Heather ; Dramowski, Angela ; Maté-Cano, Irene ; Soto, Beatriz ; Calvo, Cristina ; Santiago, B. ; Saavedra-Lozano, Jesus ; Bustinza, A. ; Escosa-García, Luis ; Ureta, N. ; Tagarro, Alfredo ; Barrero, Pedro Terol ; Rincon-Lopez, Elena Maria ; Abubakar, Ismaela ; Aston, J. ; Heginbothom, Maggie ; Satodia, P. ; Garbash, Mehdi ; Johnson, Alison ; Sharpe, D. ; Barton, Christopher ; Menson, Esse ; Arenas-Lopez, Sara ; Luck, Suzanne ; Doerholt, Katja ; McMaster, Paddy ; Caldwell, N. ; Lunn, Andrew ; Drysdale, S. ; Howe, Rachel ; Scorrer, Tim ; Gahleitner, Florian ; Gupta, Richa ; Nash, C. ; Alexander, John ; Raman, Mala ; Bell, Emily ; Rajagopal, Veena ; Kohlhoff, Stephan ; Cox, Elaine ; Zaoutis, Theoklis. / The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey : Developing hospital-quality indicators of antibiotic prescribing for children. In: Journal of Antimicrobial Chemotherapy. 2016 ; Vol. 71, No. 4. pp. 1106-1117.
@article{8fc8dd0af059497590f92c281a243e84,
title = "The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children",
abstract = "Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7{\%}) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3{\%}; Asia, 13.0{\%}; Southern Europe, 9.8{\%}), cefepime (ranked third in North America, 7.8{\%}) and meropenem (ranked first in Latin America, 13.1{\%}). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9{\%}; range from 14.2{\%} in Africa to 68.0{\%} in Latin America) compared with children (28.3{\%}; range from 14.5{\%} in Africa to 48.9{\%} in Latin America). Parenteral administration was very common among children in Asia (88{\%}), Latin America (81{\%}) and Europe (67{\%}). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52{\%}). Prolonged surgical prophylaxis rates ranged from 78{\%} (Europe) to 84{\%} (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children.",
author = "A. Versporten and Julia Bielicki and N. Drapier and Mike Sharland and Hermanon Goossens and Calle, {Graciela Maria} and Julia Clark and Celia Cooper and Blyth, {Christopher C.} and Francis, {Joshua Reginald} and Jameela Alsalman and H. Jansens and L. Mahieu and {Van Rossom}, Paul and Wouter Vandewal and Philippe Lepage and Sophie Blumental and C. Briquet and Dirk Robbrecht and Pierre Maton and P. Gabriels and Zana Rubic and Tanja Kovacevic and Nielsen, {Jens Peter} and Petersen, {Jes Reinholdt} and Porntiva Poorisrisak and L. Jensen and Mari Laan and E. Tamm and Maire Matsinen and M. Rummukainen and Vincent Gajdos and Romain Olivier and {Le Mar{\'e}chal}, Flore and Alain Martinot and S. Prot-Labarthe and Mathie Lorrot and Daniel Orbach and K. Pagava and M. Hufnagel and Markus Knuf and Schlag, {Stephanie A A} and Liese, {J. G.} and Lorna Renner and Anthony Enimil and Marah Awunyo and G. Syridou and Nikos Spyridis and Elena Critselis and Sofia Kouni and K. Mougkou and Fani Ladomenou and D. Gkentzi and E. Iosifidis and E. Roilides and Suneeta Sahu and Srinivas Murki and Manoj Malviya and Kalavalapalli, {Durga Bhavani} and Sanjeev Singh and Tanu Singhal and Garima Garg and Pankaj Garg and Neelam Kler and Jafar Soltani and Zahra Jafarpour and Gholamreza Pouladfar and G. Nicolini and Carlotta Montagnani and Luisa Galli and Susanna Esposito and Vecchio, {Andrea Lo} and Daniele Dona' and Carlo Giaquinto and Eleonora Borgia and Patrizia D'Argenio and {De Luca}, M. and Chiara Centenari and Lul Raka and Abeer Omar and {Al Mousa}, Haifaa and Dzintars Mozgis and Inese Sviestina and Sigita Burokiene and Vytautas Usonis and G. Tavchioska and Antonia Hargadon-Lowe and Peter Zarb and M. Borg and {Gonz{\'a}lez Lozano}, {Carlos Agust{\'i}n} and Casta{\~n}on, {Patricia Z{\'a}rate} and Cancino, {Martha E.} and B. McCullagh and A. McCorry and Cairine Gormley and {Al Maskari}, Zaina and Amina Al-Jardani and Magdalena Pluta and Fernanda Rodrigues and A. Brett and I. Esteves and Laura Marques and AlAjmi, {Jameela Ali} and Cambrea, {S. C.} and Rashed, {Asia N.} and {Al Azmi}, {Aeshah Abdu Mubarak} and Chan, {Si Min} and Isa, {Mas Suhaila} and Peter Najdenov and M. Cizman and S. Unuk and Heather Finlayson and Angela Dramowski and Irene Mat{\'e}-Cano and Beatriz Soto and Cristina Calvo and B. Santiago and Jesus Saavedra-Lozano and A. Bustinza and Luis Escosa-Garc{\'i}a and N. Ureta and Alfredo Tagarro and Barrero, {Pedro Terol} and Rincon-Lopez, {Elena Maria} and Ismaela Abubakar and J. Aston and Maggie Heginbothom and P. Satodia and Mehdi Garbash and Alison Johnson and D. Sharpe and Christopher Barton and Esse Menson and Sara Arenas-Lopez and Suzanne Luck and Katja Doerholt and Paddy McMaster and N. Caldwell and Andrew Lunn and S. Drysdale and Rachel Howe and Tim Scorrer and Florian Gahleitner and Richa Gupta and C. Nash and John Alexander and Mala Raman and Emily Bell and Veena Rajagopal and Stephan Kohlhoff and Elaine Cox and Theoklis Zaoutis",
year = "2016",
month = "4",
day = "1",
doi = "10.1093/jac/dkv418",
language = "English",
volume = "71",
pages = "1106--1117",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey

T2 - Developing hospital-quality indicators of antibiotic prescribing for children

AU - Versporten, A.

AU - Bielicki, Julia

AU - Drapier, N.

AU - Sharland, Mike

AU - Goossens, Hermanon

AU - Calle, Graciela Maria

AU - Clark, Julia

AU - Cooper, Celia

AU - Blyth, Christopher C.

AU - Francis, Joshua Reginald

AU - Alsalman, Jameela

AU - Jansens, H.

AU - Mahieu, L.

AU - Van Rossom, Paul

AU - Vandewal, Wouter

AU - Lepage, Philippe

AU - Blumental, Sophie

AU - Briquet, C.

AU - Robbrecht, Dirk

AU - Maton, Pierre

AU - Gabriels, P.

AU - Rubic, Zana

AU - Kovacevic, Tanja

AU - Nielsen, Jens Peter

AU - Petersen, Jes Reinholdt

AU - Poorisrisak, Porntiva

AU - Jensen, L.

AU - Laan, Mari

AU - Tamm, E.

AU - Matsinen, Maire

AU - Rummukainen, M.

AU - Gajdos, Vincent

AU - Olivier, Romain

AU - Le Maréchal, Flore

AU - Martinot, Alain

AU - Prot-Labarthe, S.

AU - Lorrot, Mathie

AU - Orbach, Daniel

AU - Pagava, K.

AU - Hufnagel, M.

AU - Knuf, Markus

AU - Schlag, Stephanie A A

AU - Liese, J. G.

AU - Renner, Lorna

AU - Enimil, Anthony

AU - Awunyo, Marah

AU - Syridou, G.

AU - Spyridis, Nikos

AU - Critselis, Elena

AU - Kouni, Sofia

AU - Mougkou, K.

AU - Ladomenou, Fani

AU - Gkentzi, D.

AU - Iosifidis, E.

AU - Roilides, E.

AU - Sahu, Suneeta

AU - Murki, Srinivas

AU - Malviya, Manoj

AU - Kalavalapalli, Durga Bhavani

AU - Singh, Sanjeev

AU - Singhal, Tanu

AU - Garg, Garima

AU - Garg, Pankaj

AU - Kler, Neelam

AU - Soltani, Jafar

AU - Jafarpour, Zahra

AU - Pouladfar, Gholamreza

AU - Nicolini, G.

AU - Montagnani, Carlotta

AU - Galli, Luisa

AU - Esposito, Susanna

AU - Vecchio, Andrea Lo

AU - Dona', Daniele

AU - Giaquinto, Carlo

AU - Borgia, Eleonora

AU - D'Argenio, Patrizia

AU - De Luca, M.

AU - Centenari, Chiara

AU - Raka, Lul

AU - Omar, Abeer

AU - Al Mousa, Haifaa

AU - Mozgis, Dzintars

AU - Sviestina, Inese

AU - Burokiene, Sigita

AU - Usonis, Vytautas

AU - Tavchioska, G.

AU - Hargadon-Lowe, Antonia

AU - Zarb, Peter

AU - Borg, M.

AU - González Lozano, Carlos Agustín

AU - Castañon, Patricia Zárate

AU - Cancino, Martha E.

AU - McCullagh, B.

AU - McCorry, A.

AU - Gormley, Cairine

AU - Al Maskari, Zaina

AU - Al-Jardani, Amina

AU - Pluta, Magdalena

AU - Rodrigues, Fernanda

AU - Brett, A.

AU - Esteves, I.

AU - Marques, Laura

AU - AlAjmi, Jameela Ali

AU - Cambrea, S. C.

AU - Rashed, Asia N.

AU - Al Azmi, Aeshah Abdu Mubarak

AU - Chan, Si Min

AU - Isa, Mas Suhaila

AU - Najdenov, Peter

AU - Cizman, M.

AU - Unuk, S.

AU - Finlayson, Heather

AU - Dramowski, Angela

AU - Maté-Cano, Irene

AU - Soto, Beatriz

AU - Calvo, Cristina

AU - Santiago, B.

AU - Saavedra-Lozano, Jesus

AU - Bustinza, A.

AU - Escosa-García, Luis

AU - Ureta, N.

AU - Tagarro, Alfredo

AU - Barrero, Pedro Terol

AU - Rincon-Lopez, Elena Maria

AU - Abubakar, Ismaela

AU - Aston, J.

AU - Heginbothom, Maggie

AU - Satodia, P.

AU - Garbash, Mehdi

AU - Johnson, Alison

AU - Sharpe, D.

AU - Barton, Christopher

AU - Menson, Esse

AU - Arenas-Lopez, Sara

AU - Luck, Suzanne

AU - Doerholt, Katja

AU - McMaster, Paddy

AU - Caldwell, N.

AU - Lunn, Andrew

AU - Drysdale, S.

AU - Howe, Rachel

AU - Scorrer, Tim

AU - Gahleitner, Florian

AU - Gupta, Richa

AU - Nash, C.

AU - Alexander, John

AU - Raman, Mala

AU - Bell, Emily

AU - Rajagopal, Veena

AU - Kohlhoff, Stephan

AU - Cox, Elaine

AU - Zaoutis, Theoklis

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children.

AB - Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children.

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U2 - 10.1093/jac/dkv418

DO - 10.1093/jac/dkv418

M3 - Article

VL - 71

SP - 1106

EP - 1117

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 4

M1 - dkv418

ER -