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BMC Pediatrics
Published in: BMC Pediatrics 1/2024

Open Access 01-12-2024 | Azithromycin | Research

Use of antimicrobials in pediatric wards of five Brazilian hospitals

Authors: Thais de Barros Fernandes, Sheila Feitosa Ramos, Luísa Rodrigues Furtado Leitzke, Ronaldo Gomes Alexandre Júnior, Janaína Morais de Araújo, Alcidésio Sales de Souza Júnior, Alice Ramos Oliveira da Silva, Isabela Heineck, Marta Maria de França Fonteles, Louise E. Bracken, Matthew Peak, Divaldo Pereira de Lyra Junior, Claudia G S Osorio-de-Castro, Elisangela Costa Lima

Published in: BMC Pediatrics | Issue 1/2024

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Abstract

The use of antimicrobials (AMs) in pediatric infections is common practice and use may be inappropriate leading to antimicrobial resistance. Off-label AM use is also common in this group and can result in drug-related problems. There is lack of DUR data in Brazil and in Latin America, specially for AM pediatric use. The aim of this study was to describe the utilization of AMs in hospitalized children in five hospitals in Brazil. We conducted an observational study of the utilization of AMs in pediatric wards in hospitals in the states of Ceará (CE), Sergipe (SE), Rio de Janeiro (RJ), Rio Grande do Sul (RS) and the Federal District (DF). Data derived from patient medical records and prescriptions were collected over a six-month period in each hospital. The number of AMs used by each patient was recorded, and AM use was assessed using Days of therapy (DOT) and Length of therapy (LOT) per 1000 patient days according to different patient characteristics. Off-label (OL) use was described according to age. The study analyzed data from 1020 patients. The sex and age distributions were similar across the five hospitals. However, differences were found for comorbidities, history of ICU admission and length of hospital stay. The most common diseases were respiratory tract infections. There were wide variations in DOT/1000PD (278–517) and LOT/1000PD (265–390). AM utilization was highest in the hospital in SE. The consumption of second-generation penicillins and cephalosporins was high. The prevalence of OL use of AMs was higher for patients in the RJ hospital, in infants, in patients who underwent prolonged hospital stays, and in patients who used multiple AMs. The AM that showed the highest prevalence of OL use was azithromycin, in both oral and parenteral formulations. Overall AM use was high and showed differences in each setting, possibly influenced by local characteristics and by prescribing standards adopted by pediatricians.
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Metadata
Title
Use of antimicrobials in pediatric wards of five Brazilian hospitals
Authors
Thais de Barros Fernandes
Sheila Feitosa Ramos
Luísa Rodrigues Furtado Leitzke
Ronaldo Gomes Alexandre Júnior
Janaína Morais de Araújo
Alcidésio Sales de Souza Júnior
Alice Ramos Oliveira da Silva
Isabela Heineck
Marta Maria de França Fonteles
Louise E. Bracken
Matthew Peak
Divaldo Pereira de Lyra Junior
Claudia G S Osorio-de-Castro
Elisangela Costa Lima
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Azithromycin
Published in
BMC Pediatrics / Issue 1/2024
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-024-04655-9

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