European Surveillance of Antibiotic Consumption (ESAC) point prevalence survey 2008: paediatric antimicrobial prescribing in 32 hospitals of 21 European countries.
BACKGROUND
Antimicrobials are the most common medicines prescribed to children, but very little is known about patterns of hospital paediatric antimicrobial prescribing. This study aimed at describing paediatric antimicrobial prescribing in European hospitals to identify targets for quality improvement.


METHODS
The European Surveillance of Antibiotic Consumption (ESAC) project (www.esac.ua.ac.be) collected data during 2 calendar weeks between May and June 2008 in 32 hospitals of 21 European countries with paediatric departments, using a standardized method. The ESAC point prevalence survey included all inpatient beds and identified all patients who were receiving systemic antimicrobials on the day of the survey or had received antimicrobial surgical prophylaxis on the previous day.


RESULTS
Of 1799 children, 583 (32%) received one or more antimicrobials (range 17%-100%). The indications were therapeutic in 71%, prophylactic in 26% and both indications in 3% of patients. The parenteral route was used in 82% of therapeutic indications and in 63% of prophylactic indications. Third-generation cephalosporins were the most prescribed antimicrobials for therapeutic indications (18%). A high proportion of treated children received antimicrobial combinations (37%). The most commonly treated diagnosis site was the respiratory tract for both therapeutic use (30%) and prophylaxis (25%). The duration of surgical prophylaxis was >1 day in 67%.


CONCLUSIONS
Targets identified for quality improvement of antimicrobial use in children included excessive use of antimicrobial combinations and a high proportion of parenteral antimicrobials, both of which require further investigation. Surgical prophylaxis for >1 day should also be curbed in order to achieve quality improvement.
Amadeo
Brice
B
INSERM unit 657, University of Bordeaux, Bordeaux, France. brice.amadeo@chu-bordeaux.fr
Zarb
Peter
P
Muller
Arno
A
Drapier
Nico
N
Vankerckhoven
Vanessa
V
Rogues
Anne-Marie
AM
Davey
Peter
P
Goossens
Herman
H
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination / Q000379:methods / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007263:Infusions, Parenteral / Q000706:statistics & numerical data; D008297:Male
D000900:Anti-Bacterial Agents