title: Current ciprofloxacin usage in children hospitalized in a referral hospital in Paris.
abstract: BACKGROUND
  Fluoroquinolones are used with increasing frequency in children with a major risk of increasing the emergence of FQ resistance. FQ use has expanded off-label for primary antibacterial prophylaxis or treatment of infections in immune-compromised children and life-threatening multi-resistant bacteria infections. Here we assessed the prescriptions of ciprofloxacin in a pediatric cohort and their appropriateness.
  
  
  METHODS
  A monocenter audit of ciprofloxacin prescription was conducted for six months in a University hospital in Paris. Infected site, bacteriological findings and indication, were evaluated in children receiving ciprofloxacin in hospital independently by 3 infectious diseases consultants and 1 hospital pharmacist.
  
  
  RESULTS
  Ninety-eight ciprofloxacin prescriptions in children, among which 52 (53.1%) were oral and 46 (46.9%) parenteral, were collected. 45 children had an underlying condition, cystic fibrosis (CF) (21) or an innate or acquired immune deficiency (24). Among CF patients, the most frequent indication was a broncho-pulmonary Pseudomonas aeruginosa infection (20). In non-CF patient, the major indications were broncho-pulmonary (25), urinary (8), intra-abdominal (7), operative site infection (5) and bloodstream/catheter (2/4) infection. 62.2% were microbiologically documented. Twenty-three (23.4%) were considered "mandatory", 48 (49.0%) "alternative" and 27 (27.6%) "unjustified".
  
  
  CONCLUSIONS
  In our university hospital, only 23.4% of fluoroquinolones prescriptions were mandatory in children, especially in Pseudomonas aeruginosa healthcare associated infection. Looking to the ecological risk of fluoroquinolones and the increase consumption in children population we think that a control program should be developed to control FQ use in children. It could be done with the help of an antimicrobial stewardship team.
authors.affiliation: Service des Maladies Infectieuses et Tropicales & Centre d'Infectiologie Necker-Pasteur, Université Paris Descartes, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Zhi-Tao
authors.initials: ZT
authors.lastname: Yang
authors.forename: Jean-Ralph
authors.initials: JR
authors.lastname: Zahar
authors.forename: Fréderic
authors.initials: F
authors.lastname: Méchaï
authors.forename: Martine
authors.initials: M
authors.lastname: Postaire
authors.forename: Stéphane
authors.initials: S
authors.lastname: Blanot
authors.forename: Sarah
authors.initials: S
authors.lastname: Balfagon-Viel
authors.forename: Xavier
authors.initials: X
authors.lastname: Nassif
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000008:administration & dosage*; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D010297:Paris; D012017:Referral and Consultation
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin