title: [Carbapenem antibiotics in hospitalised paediatric patients. Adherence to a therapeutic protocol].
abstract: OBJECTIVE
  To describe the use of carbapenems in children hospitalised outside intensive care and onco-haematology units, and assess adherence to a therapeutic protocol.
  
  
  METHODS
  A retrospective observational study was conducted on the use of carbapenems between January 2009 and December 2010. The study included children with a community-acquired infectious disease or a health care-associated infectious disease, and who were admitted to paediatric areas of the Vall d'Hebron University Hospital (Barcelona, Spain), other than intensive care, neonatology and onco-haematology units. Clinical data were collected and antibiotic consumption data were provided by the Pharmacy Department.
  
  
  RESULTS
  A total of 51 episodes fulfilled the inclusion criteria. Carbapenem as initial empirical treatment was indicated in 31.4%, and applied as rescue therapy in the remainder. The instructions of the protocol were adhered to in 70.6% of the empirical and 87.5% of the targeted prescriptions (77.6% overall). A better match was found for empirical carbapenem in patients with a previous admission or underlying condition. Factors such as diagnosis, age or antibiotic use prior to admission did not affect the empirical indication of carbapenem.
  
  
  CONCLUSIONS
  The establishment of a treatment protocol with carbapenem indications in our centre since 2007 has yielded significantly better results on the appropriateness of the prescription than those obtained in other studies.
authors.affiliation: Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Montesinos-Sanchis
authors.affiliation: Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: fmoraga@acmcb.es.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Moraga-Llop
authors.affiliation: Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Pere
authors.initials: P
authors.lastname: Soler-Palacín
authors.affiliation: Servicio de Farmacia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: María
authors.initials: M
authors.lastname: Oliveras-Arenas
authors.affiliation: Servicio de Microbiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: M Nieves
authors.initials: MN
authors.lastname: Larrosa Escartín
authors.affiliation: Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Martínez Gómez
authors.affiliation: Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Figueras-Nadal
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy*; D015780:Carbapenems / Q000627:therapeutic use*; D002675:Child, Preschool; D002985:Clinical Protocols; D017714:Community-Acquired Infections / Q000188:drug therapy; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
chemical_list: D015780:Carbapenems
keywords: Antimicrobial use; Carbapenems; Carbapenémicos; Community-acquired infection and health care-associated infection; Infección comunitaria y relacionada con asistencia sanitaria; Paediatrics; Pediatría; Uso de antimicrobianos