[Evaluation of the antibiotic prescription in a paediatric intensive care unit].
The antibiotic prescription in intensive care units is frequent using often broad-spectrum antibiotics; its quality has never been evaluated in paediatric intensive care units.


OBJECTIVE
To describe the modalities of antibiotic prescriptions in a paediatric intensive care unit and confront them to the literature guidelines and bacteriological data.


METHODS
From January 1st to March 31st 2005, 52 consecutive prescriptions regarding 45 children, with a total of 47 hospitalisations were prospectively analysed.


RESULTS
Confirmed diagnosis of bacterial infection was retained for 50 of the 52 patients: community acquired infection in 35 cases (70%) and a nosocomial infection in 15 cases. Ten children died during the antibiotic treatment (22%), with 5 deaths related to the infection (11%). Monotherapy represented 56% of the prescriptions of antibiotics. The initial antibiotic treatment was empirical in 42 of 52 cases (81%). The empirical prescriptions were documented afterward in 48% of cases. One or more microorganisms were isolated for 60% of the initial prescriptions. Misuses in antibiotic doses (in excess [10%] or by insufficiency [13%]), number of daily administration (4%), and way of administration and/or length of treatment were observed. Seventy-seven percent of the initial prescriptions seemed to be adapted to the identified or suspected bacteria, but only 63% adequate to recommendations.


CONCLUSIONS
Almost 2/3rd of the antibiotic prescriptions were adequate to the recommendations. The implementation of standardized and specific protocols should contribute to improve the quality of these prescriptions.
Audry-Degardin
E
E
Service de réanimation pédiatrique, hôpital Jeanne-de-Flandre et université de Lille-II, avenue E.-Avinée, 59037 Lille cedex, France.
Dubos
F
F
Leteurtre
S
S
Beaucaire
G
G
Leclerc
F
F
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents