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A worrying trend in weight‐adjusted paediatric antibiotic use in a Norwegian tertiary care hospital
Author(s) -
Raastad Ragnhild,
Tvete Ingunn Fride,
Abrahamsen Tore G.,
Berild Dag,
Leegaard Truls M.,
Walberg Mette,
Müller Fredrik
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12994
Subject(s) - medicine , antibiotics , defined daily dose , cephalosporin , norwegian , pediatrics , meropenem , emergency medicine , antibiotic resistance , medical prescription , linguistics , philosophy , microbiology and biotechnology , pharmacology , biology
Abstract Aim The World Health Organization recommends the defined daily dose ( DDD ) as the standard unit of measurement for antibiotic use, but this is not applicable in children. We aimed to assess paediatric antibiotic use in a Norwegian tertiary care hospital using a novel weight‐adjusted method. Methods We obtained antibiotic purchase data from the hospital pharmacy and administrative data for all admissions from 2002 to 2009 to the paediatric wards at Oslo University Hospital, Rikshospitalet. Recommended daily doses per 100 kg days ( RDD s/kg days) were calculated based on national guidelines for paediatric antibiotic use, length of stay and estimated weight for sex and age using national growth references. Results Total antibiotic use increased significantly from 51.8 to 65.5 RDD s/100 kg days. We found statistically significant annual increases in the consumption of carbapenems (18.0%), third‐generation cephalosporins (6.0%) and imidazole derivatives (6.6%) and a considerable difference between total antibiotic use measured in RDD s/100 kg days and DDD s/100 bed days for neonates. Conclusion Weight‐adjusted antibiotic use provided a more meaningful description of the quantities of antibiotics consumed than DDD s/100 bed days, particularly for neonates. Total antibiotic use, use of meropenem, third‐generation cephalosporins and imidazole derivatives increased significantly despite low prevalence of antibiotic‐resistant pathogens.