Vigilance of antibiotic use in a pediatric hospital (Hospital Pediátrico del Centro Hospitalario Pereira Rossell)
Antimicrobial susceptibility; cost and consumption antibiotics
Abstract
Background. Guidelines for empirical antibiotic treatment are a primary strategy to prevent the sustainable increased in bacterial resistance and costs. Since 1998, when a guideline for empirical antibiotic treatment for the most frequent infections in general ward and emergency units was adapted in the Hospital Pediátrico del Centro Hospitalario Pereira Rossell- HP-CHPR), this study began.
Objective. To analyze antibiotic overuse and costs, and antimicrobial susceptibility.
Method. Recommended antibiotics (by Hospital Guidelines: penicillin, aminopenicillin, cefalosporine, macrolides) costs were calculated for both general wards and emergency units. Consumption per in-hospital-patient was calculated on basis of defined daily dose (DDD)/100 day-beds for each antibiotic. Cost/consumption antibiotic for the period 2001-2002 were compared, antimicrobial susceptibility of the most frequent germens during 2001-2002 was compared to adapted therapeutic guidelines.
Results. Recommended antibiotic cost was in 2001 57% of antibiotic cost (2.206.652.57 pesos), in 2002 54% (1.441.280 pesos). Aminopenicillin was the antibiotic most frequently used. Intravenous cefuroxime consumption decreased 60% (from 13.1 to 5.36 DDD/100 day-beds). Intravenous ceftriaxone and oral amoxicillin increased 38% and 16% respectively. Consumption of other antibiotics remained constant. Antimicrobial susceptibility rates of most frequent germens (S. pseumoniae, S. aureus, E. coli, Shigella spp) to recommended antibiotics remained over 80%.
Conclusions. These are the first results of vigilance antibiotic use in HP-CHPR; they show the actuality and acceptance of the empirical antibiotic therapy guidelines proposed. Decrease in antibiotic cost is complex since cost variance during the same period.
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