One-Quarter of Antibiotic Prescriptions at Children's Hospitals Suboptimal
21 percent of these orders are suboptimal by antimicrobial stewardship program standards
WEDNESDAY, Feb. 19, 2020 (HealthDay News) -- One in three children are prescribed antibiotics at children's hospitals, and 25.9 percent prescribed antibiotics for infectious use are receiving at least one suboptimal antibiotic, according to a study recently published in Clinical Infectious Diseases.
Alison C. Tribble, M.D., from the University of Michigan in Ann Arbor, and colleagues performed a cross-sectional analysis of antibiotic prescribing for 34,927 patients at 32 U.S. children's hospitals. The authors surveyed antimicrobial stewardship program (ASP) practitioners regarding the appropriateness of prescriptions for hospitalized children with at least one antibiotic order at 8 a.m. on one day per calendar quarter from 2016 to 2017.
The researchers found that of the 11,784 patients receiving antibiotics for infectious use, 25.9 percent were prescribed at least one antibiotic that was considered to be suboptimal by ASP practices. Of a total of 17,110 antibiotic orders evaluated in the study, 21 percent were suboptimal. Bug-drug mismatch (27.7 percent), surgical prophylaxis longer than 24 hours (17.7 percent), overly broad empiric therapy (11.2 percent), and unnecessary treatment (11.0 percent) were the most common reasons for inappropriate antibiotic prescription. Notably, 46.1 percent of the suboptimal orders would not have been routinely reviewed by ASPs.
"These data underscore the need for robust programs to support optimal antibiotic use for hospitalized children," the authors write. "This study highlights the need for ASPs to look beyond current practices to identify and intervene upon additional suboptimal use and denotes areas in which to potentially expand efforts. Such evolution is imperative to ensure optimal antibiotic use for all hospitalized children."
Two authors disclosed financial ties to Merck.