Monitoring Antibiotic Consumption in Pediatrics. How Close to Reality Are Days of Therapy and Recommended Daily Dose Methods?

Autor:	Baier J; From the Department for Operative and Nonoperative Pediatrics and Adolescent Medicine, Section for Neonatology and Pediatric Critical Care, University Hospital, Halle, Germany., Höpner J; Institute for Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin Luther University of Halle-Wittenberg, Halle, Germany., Haase R; From the Department for Operative and Nonoperative Pediatrics and Adolescent Medicine, Section for Neonatology and Pediatric Critical Care, University Hospital, Halle, Germany., Diexer S; Institute for Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin Luther University of Halle-Wittenberg, Halle, Germany., Stareprawo S; University Pharmacy and., Mikolajczyk R; Institute for Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin Luther University of Halle-Wittenberg, Halle, Germany., Moritz S; Section of Clinical Infectious Diseases, University Hospital, Halle, Germany.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2022 Apr 01; Vol. 41 (4), pp. e126-e132.
DOI:	10.1097/INF.0000000000003446
Abstrakt:	Background: Hospitals are advised to monitor antibiotic use. Several approximation methods do exist to perform this task. Adult cohorts can easily be monitored using the defined daily dose method, or its German adaption recommended daily doses (RDD) method, that seems inapplicable in pediatric cohorts due to body weight variations. Guidelines recommend the days of therapy (DOT) method in pediatrics. Still, there is a need for more detailed analysis regarding the performance of both methods. Methods: Based on data from 4½ years of our fully computerized patient care data managing system in a combined neonatal and pediatric intensive care unit, we compare the results for DOT and RDD per 100 patient days with exact measurement of antibiotic consumption (individual daily dose per 100 patient days) as internal reference. Results: The DOT method reflected antibiotic consumption in our cohort on the level of total consumption, subgroups, and agents with almost always high accuracy (correlation with individual daily dose between 0.73 and 1.00). The RDD method showed poor correlation on the level of total consumption (r = 0.21) and fluctuating results on more detailed levels (correlation, 0.01-0.94). A detailed analysis of body weight distribution and ordered packaging sizes of single agents revealed that RDD seems to work well when only one package size of the agent was ordered in our pharmacy. Conclusion: The DOT method is superior to RDD for monitoring antibiotic drug consumption in pediatric cohorts. RDD seems to work satisfactory well for selected antibiotic agents that are administered with little variation in packaging size. Competing Interests: This work was funded by the country of Saxony-Anhalt, Germany. The authors have no conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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