[Reasons for inappropriate prescribing of antibiotics in a high-complexity pediatric hospital]
| Autor: | Silvina, Ruvinsky, Andrea, Mónaco, Guadalupe, Pérez, Moira, Taicz, Laura, Inda, Ivana, Kijko, Patricia, Constanzo, Rosa, Bologna |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
Cross Infection Motivation Neutropenia Fever Attitude of Health Personnel Argentina Inappropriate Prescribing Bacterial Infections Hospitals Pediatric Intensive Care Units Pediatric Drug Prescriptions Drug Utilization Anti-Bacterial Agents Congenital Abnormalities Postoperative Complications Child Preschool Neoplasms Physicians Practice Guidelines as Topic Humans Female Nervous System Diseases Child Intermediate Care Facilities |
| Zdroj: | Revista panamericana de salud publica = Pan American journal of public health. 30(6) |
| ISSN: | 1680-5348 |
| Popis: | Determine the reasons for inappropriate prescription of antibiotics and identify opportunities to improve prescription of these drugs in pediatric patients hospitalized in intermediate and intensive care units.A prospective, descriptive longitudinal study was conducted of pediatric patients in intermediate and intensive care units who received parenteral administration of antibiotics, with the exception of newborns, burn unit patients, and surgical prophylaxis patients. A univariate analysis and multiple logistic regression were performed.A total of 376 patients with a median of age of 50 months were studied (interquartile range [IQR] 14.5-127 months). Out of the total patients studied, 75% had one or more underlying conditions. A total of 40.6% of these patients had an oncologic pathology and 33.5% had neurological conditions. The remaining 25.9% had other underlying conditions. Antibiotic treatment was inappropriate in 35.6% of the patients studied (N = 134). In 73 (54.4%) of the 134 cases, inappropriate use was due to the type of antibiotic prescribed, the dose administered, or the treatment period. The 61 (45.5%) remaining cases did not require antibiotic treatment. In the multivariate analysis, the risk factors for inappropriate use of antibiotics were: administration of ceftriaxone OR 2 (95% CI, 1.3-3.7; P = 0.02); acute lower respiratory tract infection OR 1.8 (95% CI, 1.1-3.3; P0.04); onset of fever of unknown origin in hospital inpatients OR 5.55 (95% CI, 2.5-12; P0.0001); and febrile neutropenia OR 0.3 (95% CI, 0.1-0.7; P = 0.009).Inappropriate use of antibiotics was less common in the clinical conditions that were well-characterized. Prescribing practices that could be improved were identified through the preparation and circulation of guidelines for antibiotic use in hospital inpatients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|