title: Inappropriate antimicrobial use in Turkish pediatric hospitals: a multicenter point prevalence survey.
abstract: OBJECTIVE
  Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices.
  
  
  METHODS
  In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP).
  
  
  RESULTS
  A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p<0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p=0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p=0.008).
  
  
  CONCLUSIONS
  Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University, Medical School, Ankara, Turkey. mceyhan@hacettepe.edu.tr
authors.forename: M
authors.initials: M
authors.lastname: Ceyhan
authors.forename: I
authors.initials: I
authors.lastname: Yildirim
authors.forename: C
authors.initials: C
authors.lastname: Ecevit
authors.forename: A
authors.initials: A
authors.lastname: Aydogan
authors.forename: A
authors.initials: A
authors.lastname: Ornek
authors.forename: N
authors.initials: N
authors.lastname: Salman
authors.forename: A
authors.initials: A
authors.lastname: Somer
authors.forename: N
authors.initials: N
authors.lastname: Hatipoğlu
authors.forename: Y
authors.initials: Y
authors.lastname: Camcioglu
authors.forename: E
authors.initials: E
authors.lastname: Alhan
authors.forename: U
authors.initials: U
authors.lastname: Celik
authors.forename: M
authors.initials: M
authors.lastname: Hacimustafaoglu
authors.forename: S
authors.initials: S
authors.lastname: Celebi
authors.forename: D
authors.initials: D
authors.lastname: Inan
authors.forename: N
authors.initials: N
authors.lastname: Kurt
authors.forename: A F
authors.initials: AF
authors.lastname: Oner
authors.forename: O
authors.initials: O
authors.lastname: Gulumser
authors.forename: A
authors.initials: A
authors.lastname: Gunes
authors.forename: Y
authors.initials: Y
authors.lastname: Coskun
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D006776:Hospitals, Pediatric; D006801:Humans; D015995:Prevalence; D014421:Turkey / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents