Antibiotic surveillance on a paediatric intensive care unit: easy attainable strategy at low costs and resources

BMC Pediatrics

Research Article

Winston Banya¹  Anke Furck²  Eduardo Ferrao²  Duncan Macrae²  Martin Stocker³  Jamie Cheong⁴ 

[1] Epidemiology and Biostatistics, Royal Brompton and Harefield NHS Foundation Trust, London, UK;Paediatric Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK;Paediatric and Neonatal Intensive Care Unit, Children’s Hospital Lucerne, Lucerne, Switzerland;Pharmacy Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK;

关键词: Antibiotic surveillance;    Paediatric intensive care unit;    CDC 12-Step Campaign;    Checklist;    antimicrobial stewardship program;   

DOI  :  10.1186/1471-2431-12-196

 received in 2012-09-23, accepted in 2012-12-19,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAntibiotic surveillance is mandatory to optimise antibiotic therapy. Our objectives were to evaluate antibiotic use in our pediatric intensive care unit (PICU) and to implement a simple achievable intervention aimed at improving antibiotic therapy.MethodProspective, 3 months surveillance of antibiotic use on PICU (phase I) and evaluation according to the CDC 12-step campaign with development of an attainable intervention. 3 months surveillance (phase II) after implementation of intervention with comparison of antibiotic use.ResultsAppropriate antibiotic use for culture-negative infection-like symptoms and targeted therapy for proven infections were the main areas for potential improvement. The intervention was a mandatory checklist requiring indication and recording likelihood of infection at start of antibiotic therapy and a review of the continuing need for therapy at 48 h and 5 days, reasons for continuation and possible target pathogen. The percentage of appropriate empiric antibiotic therapy courses for culture-negative infection-like symptoms increased from 18% (10/53) to 74% (42/57; p<0.0001), duration of therapy <3 days increased from 18% (10/53) to 35% (20/57; p=0.05) and correct targeting of pathogen increased from 58% (7/12) to 83% (20/24; p=0.21).ConclusionsAntibiotic surveillance using the CDC 12-step campaign can help to evaluate institutional antibiotic therapy. Development of an attainable intervention using a checklist can show improved antibiotic use with minimal expense.

【 授权许可】

CC BY   
© Stocker et al.; licensee BioMed Central Ltd. 2012