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Abstract
Objectives To describe and compare antibiotic use in relation to indications, doses, adherence rate to guidelines and rates of broad-spectrum antibiotics (BSA) in two different paediatric departments with different academic cultures, and identify areas with room for improvement.
Design Prospective observational survey of antibiotic use.
Setting Paediatric departments in a university hospital (UH) and a district hospital (DH) in Norway, 2017. The registration period was 1 year at the DH and 4 months at the UH.
Participants 201 children at the DH (mean age 3.8: SD 5.1) and 137 children at the UH (mean age 2.0: SD 5.9) were treated with systemic antibiotics by a paediatrician in the study period and included in the study.
Outcome measures Main outcome variables were prescriptions of antibiotics, treatments with antibiotics, rates of BSA, median doses and adherence rate to national guidelines.
Results In total, 744 prescriptions of antibiotics were given at the UH and 638 at the DH. Total adherence rate to guidelines was 75% at the UH and 69% at the DH (p=0.244). The rate of treatments involving BSA did not differ significantly between the hospitals (p=0.263). Use of BSA was related to treatment of central nervous system (CNS) infections, patients with underlying medical conditions or targeted microbiological treatment in 92% and 86% of the treatments, at the UH and DH, respectively (p=0.217). A larger proportion of the children at the DH were treated for respiratory tract infections (p<0.01) compared with the UH. Children at the UH were treated with higher doses of ampicillin and cefotaxime (p<0.05) compared with the DH.
Conclusion Our results indicate that Norwegian paediatricians have a common understanding of main aspects in rational antibiotic use independently of working in a UH or DH. Variations in treatment of respiratory tract infections and in doses of antibiotics should be further studied.
- epidemiology
- infection control
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Footnotes
Contributors CMT, DB, HSB and BHE were involved in the development of the protocol. CMT developed the registration form and was responsible for the data collection at Ålesund Hospital. IA was responsible for the data collection at Oslo University Hospital, Ullevål. CMT and TÅM did the analyses. CMT wrote the first draft. All the authors contributed to the interpretation of the data and revisions of the manuscript and approved the final version of the manuscript.
Funding This work was supported by a grant from Møre and Romsdal Hospital Trust (2018/1527-3).
Competing interests None declared.
Ethics approval The study was approved by the Regional Committee for Medical and Health Research Ethics (2017/30/REK Midt) and by the Local Data Protection Officials at the two hospitals.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Datafiles with deidentified patient data from the registration in both hospitals are kept by the first author and are available from him upon request. The project protocol is attached in this submission.
Correction notice This article has been corrected since it first published. Supplementary file 2 and Table 3 have been updated.
Patient consent for publication Obtained.