title: Antimicrobial use over a four-year period using days of therapy measurement at a Canadian pediatric acute care hospital.
abstract: BACKGROUND
  Antimicrobial resistance is a concern that is challenging the ability to treat common infections. Surveillance of antimicrobial use in pediatric acute care institutions is complicated because the common metric unit, the defined daily dose, is problematic for this population.
  
  
  OBJECTIVE
  During a four-year period in which no specific antimicrobial stewardship initiatives were conducted, pediatric antimicrobial use was quantified using days of therapy (DOT) per 100 patient days (PD) (DOT/100 PD) at the Alberta Children's Hospital (Calgary, Alberta) for benchmarking purposes.
  
  
  METHODS
  Drug use data for systemic antimicrobials administered on wards at the Alberta Children's Hospital were collected from electronic medication administration records. DOT were calculated and rates were determined using 100 PD as the denominator. Changes over the surveillance period and subgroup proportions were represented graphically and assessed using linear regression.
  
  
  RESULTS
  Total antimicrobial use decreased from 93.6 DOT/100 PD to 75.7 DOT/100 PD (19.1%) over the 2010/2011 through to the 2013/2014 fiscal years. During this period, a 20.0% increase in PD and an essentially stable absolute count of DOT (2.9% decrease) were observed. Overall, antimicrobial use was highest in the pediatric intensive care and oncology units.
  
  
  CONCLUSIONS
  The exact changes in prescribing patterns that led to the observed reduction in DOT/100 PD with associated increased PD are unclear, but may be a topic for future investigations.
  
  
  CONCLUSIONS
  Antimicrobial use data from a Canadian acute care pediatric hospital reported in DOT/100 PD were compiled for a four-year time period. These data may be useful for benchmarking purposes.
authors.affiliation: Department of Pharmacy Services, Alberta Health Services, Calgary; ; O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta;
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Dalton
authors.affiliation: Department of Pharmacy Services, Alberta Health Services, Calgary; ; School of Pharmacy, University of Waterloo, Waterloo, Ontario;
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: MacTavish
authors.affiliation: Department of Pharmacy Services, Alberta Health Services, Calgary; ; School of Pharmacy, University of Waterloo, Waterloo, Ontario; ; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary;
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Bresee
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases, University of Calgary; ; Department of Medicine, Cumming School of Medicine, University of Calgary; ; Alberta Children's Hospital Research Institute, Alberta Health Services, University of Calgary, Calgary, Alberta.
authors.forename: Nipunie
authors.initials: N
authors.lastname: Rajapakse
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases, University of Calgary; ; Department of Medicine, Cumming School of Medicine, University of Calgary; ; Alberta Children's Hospital Research Institute, Alberta Health Services, University of Calgary, Calgary, Alberta.
authors.forename: Otto
authors.initials: O
authors.lastname: Vanderkooi
authors.affiliation: Department of Pediatrics, Section of Infectious Diseases, University of Calgary; ; Department of Medicine, Cumming School of Medicine, University of Calgary; ; Alberta Children's Hospital Research Institute, Alberta Health Services, University of Calgary, Calgary, Alberta.
authors.forename: Joseph
authors.initials: J
authors.lastname: Vayalumkal
authors.affiliation: Alberta Children's Hospital Research Institute, Alberta Health Services, University of Calgary, Calgary, Alberta ; Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta ; Synder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta ; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
authors.forename: John
authors.initials: J
authors.lastname: Conly
keywords: Antimicrobial stewardship; Antimicrobial use; Days of therapy; Pediatric; Surveillance