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

Developing hospital-quality indicators of antibiotic prescribing for children

ARPEC project group

Research output: Contribution to journalArticle

57 Citations (Scopus)

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 (US)
Article numberdkv418
Pages (from-to)1106-1117
Number of pages12
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number4
DOIs
StatePublished - 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

@article{feea1932bd8c4a869181256394b7af24,
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 = "{ARPEC project group} and Ann Versporten and Julia Bielicki and Nico 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 Hilde Jansens and Ludo Mahieu and {Van Rossom}, Paul and Wouter Vandewal and Philippe Lepage and Sophie Blumental and Caroline Briquet and Dirk Robbrecht and Pierre Maton and Patrick Gabriels and Zana Rubic and Tanja Kovacevic and Nielsen, {Jens Peter} and Petersen, {Jes Reinholdt} and Porntiva Poorisrisak and Jensen, {Lise Heilmann} and Mari Laan and Eda Tamm and Maire Matsinen and Rummukainen, {Maija Liisa} and Vincent Gajdos and Romain Olivier and {Le Mar{\'e}chal}, Flore and Alain Martinot and Sonia Prot-Labarthe and Mathie Lorrot and Daniel Orbach and Karaman Pagava and Markus Hufnagel and Markus Knuf and Schlag, {Stephanie A A} and Johannes Liese and Lorna Renner and Anthony Enimil and Marah Awunyo and Garyfallia Syridou and Nikos Spyridis and Elena Critselis and Elaine Cox",
year = "2016",
month = "4",
day = "1",
doi = "10.1093/jac/dkv418",
language = "English (US)",
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 - ARPEC project group

AU - Versporten, Ann

AU - Bielicki, Julia

AU - Drapier, Nico

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, Hilde

AU - Mahieu, Ludo

AU - Van Rossom, Paul

AU - Vandewal, Wouter

AU - Lepage, Philippe

AU - Blumental, Sophie

AU - Briquet, Caroline

AU - Robbrecht, Dirk

AU - Maton, Pierre

AU - Gabriels, Patrick

AU - Rubic, Zana

AU - Kovacevic, Tanja

AU - Nielsen, Jens Peter

AU - Petersen, Jes Reinholdt

AU - Poorisrisak, Porntiva

AU - Jensen, Lise Heilmann

AU - Laan, Mari

AU - Tamm, Eda

AU - Matsinen, Maire

AU - Rummukainen, Maija Liisa

AU - Gajdos, Vincent

AU - Olivier, Romain

AU - Le Maréchal, Flore

AU - Martinot, Alain

AU - Prot-Labarthe, Sonia

AU - Lorrot, Mathie

AU - Orbach, Daniel

AU - Pagava, Karaman

AU - Hufnagel, Markus

AU - Knuf, Markus

AU - Schlag, Stephanie A A

AU - Liese, Johannes

AU - Renner, Lorna

AU - Enimil, Anthony

AU - Awunyo, Marah

AU - Syridou, Garyfallia

AU - Spyridis, Nikos

AU - Critselis, Elena

AU - Cox, Elaine

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

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VL - 71

SP - 1106

EP - 1117

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

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M1 - dkv418

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