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Publication Details

Title :

Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study

Journal:

Annals of Clinical Microbiology and Antimicrobials

Impact Factor:

3.924

Authors:

Balkhy HH1,2,3, El-Saed A4,5,6, AlShehri A7, Alshaalan M8, Hijazi O9, El-Metwally A4, Aljohany SM10, Al Saif S11.

Affiliations:

1 King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. balkhyh@hotmail.com.

2 King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. balkhyh@hotmail.com.

3 Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), P.O. Box 22490, Riyadh, 11426, Saudi Arabia. balkhyh@hotmail.com.

4 King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

5 Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), P.O. Box 22490, Riyadh, 11426, Saudi Arabia.

6 Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

7 Pediatric Intensive Care, King Abdullah Specialized Children’s Hospital, MNGHA, Riyadh, Saudi Arabia.

8 Department of Pediatrics, Infectious Disease Division, KAMC, MNGHA, Riyadh, Saudi Arabia.

9 Pediatric Cardiothoracic Intensive Care Unit, KAMC, MNGHA, Riyadh, Saudi Arabia.

10 Pathology and Laboratory Medicine Department, KAMC, MNGHA, Riyadh, Saudi Arabia.

11 Neonatal Intensive Care, King Abdullah Specialized Children’s Hospital, MNGHA, Riyadh, Saudi Arabia.

Year of Publication:

2019

DOI:

10.1186/s12941-019-0320-2.

Abstract:

BACKGROUND:
Despite their critical role in antimicrobial stewardship programs, data on antimicrobial consumption among the pediatric and neonatal population is limited internationally and lacking in Saudi Arabia. The current study was done as part of our antimicrobial stewardship activities.

OBJECTIVES:
To calculate overall and type-specific antimicrobial consumption.

METHODS:
A prospective surveillance study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between October 2012 and June 2015 in two pediatric and one neonatal intensive care units (ICUs). Consumption data were collected manually on a daily basis by infection control practitioners. Data were presented as days of therapy (DOT) per 1000 patient-days and as frequency of daily consumption.

RESULTS:
During the 33 months of the study, a total of 30,110 DOTs were monitored during 4921 admissions contributing 62,606 patient-days. Cephalosporins represented 38.0% of monitored antimicrobials in pediatric ICUs followed by vancomycin (21.9%), carbapenems (14.0%), aminoglycosides (8.8%), and piperacillin/tazobactam (8.8%). Their consumption rates were 265.1, 152.6, 97.6, 61.4, and 61.4 DOTs per 1000 patient-days (respectively). Aminoglycosides represented 45.4% of monitored antimicrobials in neonatal ICU followed by cephalosporins (30.4%) vancomycin (13.6%), and carbapenems (8.3%). Their consumption rates were 147.5, 98.7, 44.3, and 27 DOTs per 1000 patient-days (respectively).

CONCLUSION:
Cephalosporins are frequently used in pediatric ICU while aminoglycosides are frequently used in neonatal ICU. The local consumption of cephalosporins and carbapenems in both ICUs is probably higher than international levels. Such data can help in establishing and monitoring the functions of antimicrobial stewardship activities aiming to ensure judicious consumption of antimicrobials.