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Open Access 01-12-2023 | Urinary Tract Infection | Research

Quality indicators for appropriate antibiotic prescribing in urinary tract infections in children

Authors: Konstantinos Vazouras, Charlotte Jackson, Laura Folgori, Anastasia Anastasiou-Katsiardani, Yingfen Hsia, Romain Basmaci

Published in: BMC Infectious Diseases | Issue 1/2023

Abstract

Background

The aim of this study was to define a set of urinary tract infections (UTIs)-specific quality indicators for appropriate prescribing in children and evaluate clinical practices in a district general hospital in Greece.

Methods

The UTIs-specific quality indicators were informed by a review of the existing literature. Quality indicators were selected to describe the overall antibiotics use, prescribing patterns and UTIs clinical management regarding treatment and prophylaxis in a cohort of children admitted with a UTI. Microbiological, clinical and prescribing data about dosing, duration and route of administration were collected from the patients’ electronic health records.

Results

Twelve quality indicators were adapted or developed for prescribing in childhood UTIs. A broad variety of antibiotics were prescribed for UTIs, with a drug utilization (DU) 90% rate of 6 and 9 different antibiotics for febrile and afebrile UTIs, respectively. Despite the low incidence of multi-drug resistant UTIs in the study period (9/261, 3.4%), broad-spectrum antibiotics were prescribed in 33.5% (164/490) of prescriptions. A total of 62.8% (164/261) of patients were started on empiric combined therapies, while opportunities to de-escalate were missed in 37.8% (62/164) of them. One quarter (67/261, 25.7%) of patients did not fulfil the criteria for receiving treatment, while nearly half of those prescribed prophylaxis (82/175, 46.9%) could have avoided having a prophylaxis prescription.

Conclusions

Our study identified substantial gaps for improvement in antimicrobial prescribing for UTIs in children. The application of the proposed quality indicators could help to limit unnecessary antibiotics use in children with UTI.

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Title: Quality indicators for appropriate antibiotic prescribing in urinary tract infections in children
Authors: Konstantinos Vazouras
Charlotte Jackson
Laura Folgori
Anastasia Anastasiou-Katsiardani
Yingfen Hsia
Romain Basmaci
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Urinary Tract Infection
Antibiotic
Cephalosporin Antibiotic
Nitrofurantoin
Amikacin
Published in: BMC Infectious Diseases / Issue 1/2023
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-023-08356-z

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