Establishing a baseline for a national paediatric antimicrobial stewardship programme

C.L. Gibbons, W. Malcolm, J. Sneddon, C. Doherty, S. Cairns, A. Milne, M. Llano, J.S. Reilly

Research output: Contribution to journalArticle

Abstract

Background
The majority of antimicrobial stewardship programmes focus on prescribing in adult populations; however, there is a recognized need for targeted paediatric antimicrobial stewardship to improve the quality and safety of prescribing amongst this patient group.

Objectives
To describe the current epidemiology of antimicrobial prescribing in paediatric inpatient populations in Scotland to establish a baseline of evidence and identify priority areas for quality improvement to support a national paediatric antimicrobial stewardship programme.

Methods
A total of 559 paediatric inpatients were surveyed during the Scottish national point prevalence survey of healthcare-associated infections and antimicrobial prescribing, 2016. The prevalence of antimicrobial prescribing was calculated and characteristics of antimicrobial prescribing were described as proportions and compared between specialist hospitals and paediatric wards in acute hospitals.

Results
Prevalence of antimicrobial use in paediatric inpatients was 35.4% (95% CI¿=¿31.6%–39.4%). Treatment of community- and hospital-acquired infections accounted for 47.1% and 20.7% of antimicrobial use, respectively, with clinical sepsis being the most common diagnosis and gentamicin the most frequently prescribed antimicrobial for the treatment of infection. The reason for prescribing was documented in the notes for 86.5% of all prescriptions and, of those assessed for compliance against local policy, 92.9% were considered compliant.

Conclusions
Data from national prevalence surveys are advantageous when developing antimicrobial stewardship programmes. Results have highlighted differences in the prescribing landscape between paediatric inpatient populations in specialist hospitals and acute hospitals, and have informed priorities for the national antimicrobial stewardship programme, which reinforces the need for a targeted paediatric antimicrobial stewardship programme.
Original languageEnglish
JournalJournal of Antimicrobial Chemotherapy
DOIs
Publication statusPublished - 12 Jul 2019

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Pediatrics
Inpatients
Cross Infection
Population
Community-Acquired Infections
Pediatric Hospitals
Community Hospital
Scotland
Quality Improvement
Gentamicins
Compliance
Prescriptions
Sepsis
Epidemiology
Safety
Therapeutics
Infection
Surveys and Questionnaires

Cite this

Gibbons, C.L. ; Malcolm, W. ; Sneddon, J. ; Doherty, C. ; Cairns, S. ; Milne, A. ; Llano, M. ; Reilly, J.S. / Establishing a baseline for a national paediatric antimicrobial stewardship programme. In: Journal of Antimicrobial Chemotherapy. 2019.
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abstract = "BackgroundThe majority of antimicrobial stewardship programmes focus on prescribing in adult populations; however, there is a recognized need for targeted paediatric antimicrobial stewardship to improve the quality and safety of prescribing amongst this patient group.ObjectivesTo describe the current epidemiology of antimicrobial prescribing in paediatric inpatient populations in Scotland to establish a baseline of evidence and identify priority areas for quality improvement to support a national paediatric antimicrobial stewardship programme.MethodsA total of 559 paediatric inpatients were surveyed during the Scottish national point prevalence survey of healthcare-associated infections and antimicrobial prescribing, 2016. The prevalence of antimicrobial prescribing was calculated and characteristics of antimicrobial prescribing were described as proportions and compared between specialist hospitals and paediatric wards in acute hospitals.ResultsPrevalence of antimicrobial use in paediatric inpatients was 35.4{\%} (95{\%} CI¿=¿31.6{\%}–39.4{\%}). Treatment of community- and hospital-acquired infections accounted for 47.1{\%} and 20.7{\%} of antimicrobial use, respectively, with clinical sepsis being the most common diagnosis and gentamicin the most frequently prescribed antimicrobial for the treatment of infection. The reason for prescribing was documented in the notes for 86.5{\%} of all prescriptions and, of those assessed for compliance against local policy, 92.9{\%} were considered compliant.ConclusionsData from national prevalence surveys are advantageous when developing antimicrobial stewardship programmes. Results have highlighted differences in the prescribing landscape between paediatric inpatient populations in specialist hospitals and acute hospitals, and have informed priorities for the national antimicrobial stewardship programme, which reinforces the need for a targeted paediatric antimicrobial stewardship programme.",
author = "C.L. Gibbons and W. Malcolm and J. Sneddon and C. Doherty and S. Cairns and A. Milne and M. Llano and J.S. Reilly",
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Establishing a baseline for a national paediatric antimicrobial stewardship programme. / Gibbons, C.L.; Malcolm, W.; Sneddon, J.; Doherty, C.; Cairns, S.; Milne, A.; Llano, M.; Reilly, J.S.

In: Journal of Antimicrobial Chemotherapy, 12.07.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Establishing a baseline for a national paediatric antimicrobial stewardship programme

AU - Gibbons, C.L.

AU - Malcolm, W.

AU - Sneddon, J.

AU - Doherty, C.

AU - Cairns, S.

AU - Milne, A.

AU - Llano, M.

AU - Reilly, J.S.

N1 - Acceptance from webpage AAM: requested as file uploaded is marked 'submitted' in Pure AAM: 12m embargo

PY - 2019/7/12

Y1 - 2019/7/12

N2 - BackgroundThe majority of antimicrobial stewardship programmes focus on prescribing in adult populations; however, there is a recognized need for targeted paediatric antimicrobial stewardship to improve the quality and safety of prescribing amongst this patient group.ObjectivesTo describe the current epidemiology of antimicrobial prescribing in paediatric inpatient populations in Scotland to establish a baseline of evidence and identify priority areas for quality improvement to support a national paediatric antimicrobial stewardship programme.MethodsA total of 559 paediatric inpatients were surveyed during the Scottish national point prevalence survey of healthcare-associated infections and antimicrobial prescribing, 2016. The prevalence of antimicrobial prescribing was calculated and characteristics of antimicrobial prescribing were described as proportions and compared between specialist hospitals and paediatric wards in acute hospitals.ResultsPrevalence of antimicrobial use in paediatric inpatients was 35.4% (95% CI¿=¿31.6%–39.4%). Treatment of community- and hospital-acquired infections accounted for 47.1% and 20.7% of antimicrobial use, respectively, with clinical sepsis being the most common diagnosis and gentamicin the most frequently prescribed antimicrobial for the treatment of infection. The reason for prescribing was documented in the notes for 86.5% of all prescriptions and, of those assessed for compliance against local policy, 92.9% were considered compliant.ConclusionsData from national prevalence surveys are advantageous when developing antimicrobial stewardship programmes. Results have highlighted differences in the prescribing landscape between paediatric inpatient populations in specialist hospitals and acute hospitals, and have informed priorities for the national antimicrobial stewardship programme, which reinforces the need for a targeted paediatric antimicrobial stewardship programme.

AB - BackgroundThe majority of antimicrobial stewardship programmes focus on prescribing in adult populations; however, there is a recognized need for targeted paediatric antimicrobial stewardship to improve the quality and safety of prescribing amongst this patient group.ObjectivesTo describe the current epidemiology of antimicrobial prescribing in paediatric inpatient populations in Scotland to establish a baseline of evidence and identify priority areas for quality improvement to support a national paediatric antimicrobial stewardship programme.MethodsA total of 559 paediatric inpatients were surveyed during the Scottish national point prevalence survey of healthcare-associated infections and antimicrobial prescribing, 2016. The prevalence of antimicrobial prescribing was calculated and characteristics of antimicrobial prescribing were described as proportions and compared between specialist hospitals and paediatric wards in acute hospitals.ResultsPrevalence of antimicrobial use in paediatric inpatients was 35.4% (95% CI¿=¿31.6%–39.4%). Treatment of community- and hospital-acquired infections accounted for 47.1% and 20.7% of antimicrobial use, respectively, with clinical sepsis being the most common diagnosis and gentamicin the most frequently prescribed antimicrobial for the treatment of infection. The reason for prescribing was documented in the notes for 86.5% of all prescriptions and, of those assessed for compliance against local policy, 92.9% were considered compliant.ConclusionsData from national prevalence surveys are advantageous when developing antimicrobial stewardship programmes. Results have highlighted differences in the prescribing landscape between paediatric inpatient populations in specialist hospitals and acute hospitals, and have informed priorities for the national antimicrobial stewardship programme, which reinforces the need for a targeted paediatric antimicrobial stewardship programme.

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DO - 10.1093/jac/dkz291

M3 - Article

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

ER -