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[Prescription and use of antibiotics at a pediatric intensive care unit in Buenos Aires City].

Abstract：

INTRODUCTION:Antibiotics are the most prescribed drugs in pediatric intensive care units (PICU) with high impact in pathogens resistance and costs. OBJECTIVES:Evaluate prescription patterns and consumption of antibiotics. MATERIALS AND METHODS:From July 2006 to January 2007, monthly cross-sectional cuts were done on antibiotics use at the 1st and 7th days of prescription. A monthly antibiotics consumption average was then calculated. RESULTS:Of 81 patients, 41 received antibiotics, of which 34 were treated for at least seven days. INDICATORS:1. Mean antibiotics / patient: 83 antibiotics were used at the initial empirical treatment (meropenem 18%, vancomycin 16.8%, amikacin 16.8%, cefotaxime 13.2%, ceftazidime 6%, clarithromycin 6%, piperacillin-tazobactam 4.8%, colistin 4.8%). mean: 2 antibiotics/patient. 98 antibiotics were used at the 7th day (vancomycin 17.3%, meropenem 16.3%, amikacin 9.8%, minocycline 9.8%, colistin 9.1%, amphotericin 6.1%, trimethoprim-sulfamethoxazole 4%, ceftazidime 5.1%). Mean: 2.8 antibiotics/patient. 2. Percentage of specimen obtained: Blood culture 100%, tracheal aspirate 68%, catheter culture 54.5% 3. Percentage of patients with positive culture: Pathogens were isolated in 56.1%, of which: Bacteria in 94.3%, Gram negative non fermenting strains, in 60.6%, Enterobacteriaceae in 24.2%, Gram positive cocci in 15% and Fungi in 5.7%. 4. Percentage of adjusted antibiotic scheme: 52%. 5. Percentage of interrupted antibiotics with negative culture: 22.2%. Monthly average of consumption was: meropenem 13.44; vancomycin 10.2; cefotaxime 3.6; ceftriaxone 2.20; piperacillin-tazobactam 7.38, amikacin 2.3. CONCLUSIONS:Vancomicyn and carbapenems were the antibiotics of greater use as initial empirical treatment. The initial empirical scheme would have to be adjusted to the microbiological results in order to obtain a more prudent antibiotic use.

journal_name

Arch Argent Pediatr

journal_title

Archivos argentinos de pediatria

authors

Bidone N,Giglio N,Bakir J,Sheehan MG,Arias López MP,Rosin M,Farías J,Procopio A,Gentile A

doi

10.1590/S0325-00752008000500007

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

409-15

issue

eissn

0325-0075

issn

1668-3501

pii

S0325-00752008000500007

journal_volume

106

pub_type

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[Prescription and use of antibiotics at a pediatric intensive care unit in Buenos Aires City].