Dataset Information

Prevalence of antibiotic use in a tertiary care hospital in Italy, 2008-2016.

ABSTRACT:

Background

Few data are available about temporal trends of antibiotic use in hospitalized children. The aim of the current study was to investigate the pattern and trends of antibiotic use over the years 2008-2016 in the largest children's hospital in Italy.

Methods

Annual point prevalence surveys of antibiotic use were conducted by reviewing medical charts of 0-17?year-old children hospitalized for ?48?h. Prevalence of antibiotic use was computed by year, type of ward and indication. Trends in prevalence over time were evaluated using the Cochrane-Armitage test. Possibile determinants of antibiotic use were assessed at univariate analysis and through a logistic regression model.

Results

Out of 3015 children, 1516 (50.3%) received antibiotics, 58.1% of which for medical/surgical prophylaxis. Prevalence of antibiotic use increased from 42.0% in 2008 to 56.2% in 2016 (p?=?0.001). The prevalence of patients receiving antibiotics for medical prophylaxis increased from 6.1% in 2008 to 24.2% in 2016 (p?adj: 1.4 in case of LOS between 8 and 30?days compared to LOS???7?days, p?ConclusionsComparing prevalence rates of antibiotic use among hospitals and over time should consider differences in patient characteristics, such as age, ward of hospitalization and length of stay. Over the years, we documented an improvement in the choice of antibiotics prescribed for medical and surgical prophylaxis. However, further efforts are needed to avoid antibiotic misuse for medical prophylaxis, and to reduce the empirical use of broad spectrum antibiotics.

SUBMITTER: Ciofi Degli Atti ML

PROVIDER: S-EPMC6528368 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prevalence of antibiotic use in a tertiary care hospital in Italy, 2008-2016.

Ciofi Degli Atti Marta Luisa ML D'Amore Carmen C Ceradini Jacopo J Paolini Valerio V Ciliento Gaetano G Chessa Giuseppe G Raponi Massimiliano M

Italian journal of pediatrics 20190520 1

<h4>Background</h4>Few data are available about temporal trends of antibiotic use in hospitalized children. The aim of the current study was to investigate the pattern and trends of antibiotic use over the years 2008-2016 in the largest children's hospital in Italy.<h4>Methods</h4>Annual point prevalence surveys of antibiotic use were conducted by reviewing medical charts of 0-17 year-old children hospitalized for ≥48 h. Prevalence of antibiotic use was computed by year, type of ward and indicat ...[more]

PMID: 31109362

Similar Datasets

Project description:ContextThe increase and global dissemination of antibiotic resistance limit the use of antibiotics to prevent and treat infections. Implementing antibiotic stewardship programs guided by local data on prescription profiles is a useful strategy to reduce the burden of antibiotic resistance. The aim was to determine the prevalence of antibiotic use and guideline compliance at Luang Prabang provincial hospital, Lao PDR.MethodsA point prevalence survey of antibiotics was conducted among hospitalized patients admitted to Luang Prabang hospital (204 beds) in Lao PDR on May 25, 2023. All patients presenting at 8:00 AM were eligible. Sociodemographic data, indications for antibiotic use, and antibiotic prescriptions were collected from medical records using a paper-based questionnaire and entered into an electronic platform following WHO methodology. The prevalence of antibiotic use was determined.ResultsOut of the 102 patients included, 60(58.8%) were undergoing antibiotic treatment, of which 33(55.0%) received combination therapy, and 7(10.5%) had two indications for antibiotic use. The highest prevalence was in the surgical ward (14/15, 93%) followed by general paediatrics (18/27, 67%). Out of the 100 antibiotic prescriptions, 47(47%) were for community-acquired infections, 26(26%) for surgical prophylaxis, 13(13%) for hospital-acquired infections and 5(5%) for medical prophylaxis. Twenty(20%) antibiotics were prescribed for obstetrics and gynaecology prophylaxis, 17(17%) for intra-abdominal infections, and 10(10.0%) for pneumonia treatment as well as bone, and joint infections. The main antibiotics prescribed were ceftriaxone 36(34.6%), metronidazole 18(17.3%), ampicillin 8(7.7%), and gentamicin 8(7.7%). Only 2(3%) samples were sent to the laboratory, one of which showed a positive culture for Escherichia coli Extended Spectrum β-Lactamase. According to the WHO Access Watch and Reserve classification, 55(52.9%) molecules belonged to the Access category, 47(49.1%) to the Watch category, and none to the Reserve category. Only 14.9% of antibiotic prescriptions were fully compliant with current guidelines.ConclusionThis study indicated a significant prevalence of antibiotic use and a very low compliance with guidelines at Luang Prabang provincial hospital, Lao PDR. This highlights an urgent need for comprehensive strategies at all levels to optimize antibiotic use in hospitals, emphasizing diagnostic improvements, and continued research to address the factors driving this excessive antibiotic usage and improve adherence to guidelines.

Project description:ImportanceDermatologists prescribe more oral antibiotic courses per clinician than any other specialty, and this use puts patients at risk of antibiotic-resistant infections and antibiotic-associated adverse events.ObjectiveTo characterize the temporal trends in the diagnoses most commonly associated with oral antibiotic prescription by dermatologists, as well as the duration of this use.Design, setting, and participantsRepeated cross-sectional analysis of antibiotic prescribing by dermatologists from January 1, 2008, to December 31, 2016. The setting was Optum Clinformatics Data Mart (Eden Prairie, Minnesota) deidentified commercial claims data. Participants were dermatology clinicians identified by their National Uniform Claim Committee taxonomy codes, and courses of oral antibiotics prescribed by these clinicians were identified by their National Drug Codes.ExposuresClaims for oral antibiotic prescriptions were consolidated into courses of therapy and associated with the primary diagnosis from the most recent visit. Courses were stratified into those of extended duration (>28 days) and those of short duration (≤28 days).Main outcomes and measuresFrequency of antibiotic prescribing and associated diagnoses. Poisson regression models were used to assess for changes in the frequency of antibiotic prescribing over time.ResultsBetween 2008 and 2016 among 985 866 courses of oral antibiotics prescribed by 11 986 unique dermatologists, overall antibiotic prescribing among dermatologists decreased 36.6% (1.23 courses per 100 visits) from 3.36 (95% CI, 3.34-3.38) to 2.13 (95% CI, 2.12-2.14) courses per 100 visits with a dermatologist (prevalence rate ratio for annual change, 0.931; 95% CI, 0.930-0.932), with much of this decrease occurring among extended courses for acne and rosacea. Oral antibiotic use associated with surgical visits increased 69.6% (2.73 courses per 100 visits) from 3.92 (95% CI, 3.83-4.01) to 6.65 (95% CI, 6.57-6.74) courses per 100 visits associated with a surgical visit (prevalence rate ratio, 1.061; 95% CI, 1.059-1.063).Conclusions and relevanceContinuing to develop alternatives to oral antibiotics for noninfectious conditions, such as acne, can improve antibiotic stewardship and decrease complications from antibiotic use. In addition, the rising use of postoperative antibiotics after surgical visits is concerning and may put patients at unnecessary risk of adverse events. Future studies are needed to identify the value of this practice and the risk of adverse events.

Project description:IntroductionResponsible for at least one in nine pediatric deaths, diarrheal diseases are the leading, global cause of death. Further abetted by improper antibiotic use in a hospital setting, children with acute watery diarrhea can see prolonged hospital stays, and unwanted adverse effects such as antibiotic resistance. Hence, this study is aimed to identify the association between antibiotic usage for the treatment of acute watery diarrhea in children, and the impact this line of management has on the duration of their hospital stay.MethodsA retrospective review was conducted at the department of Pediatric of Aga Khan University Hospital (AKUH) in Karachi. A total of 305 records of children aged 6 months to 5 years who were admitted with a diagnosis of acute watery diarrhea from June 2017 -December 2018 was screened, of which 175 fulfilled the eligibility criteria. A predesigned questionnaire was used to collect demographic information, comorbidities, and clinical features, severity of dehydration, clinical examination, treatment received, and laboratory investigations. The primary outcome of this study was the length of hospital stay measured against the number of hours a child stayed in hospital for treatment of acute watery diarrhea. The statistical analysis was carried out using STATA version 14 to reach conclusive results.Results175 patients presented with acute watery diarrhea, out of which 106 (60.6%) did not receive antibiotics. The median (IQR) age of the group that did not receive antibiotics was 12.0 (12.0) months compared to 15.0 (12.0) months for the group that did receive antibiotics. In both groups, there were more males than females, less than 15% of the patients were severely malnourished (WHZ score -3SD) and less than 10% of the patients were severely dehydrated. The median (IQR) length of hospital stay (hours) was 32.0 (19.0) respectively for the group that did not receive antibiotic and 41.0 (32.0) for the group that did receive antibiotic therapy. The expected length of hospital stay for the group that received antibiotic therapy was 0.22 hours higher than the group that did not. Finally, as compared to females, hospital stay for males was longer by 0.25 hours.ConclusionIn conclusion, antibiotic use was associated with a prolonged hospital stay in children with acute watery diarrhea as compared to children who did not receive antibiotics. Large scale robust prospective studies are needed to establish this association using this observational data.

Project description:ImportanceHospital advertising has been touted as a tool to improve consumer decision-making, but little is known about its association with objective measures of hospital quality.ObjectiveTo document recent trends in hospital advertising in the US and examine the association between concurrent measures of hospital advertising and quality.Design, setting, and participantsRetrospective cross-sectional study of all general acute care hospitals operating in the US between January 2008 and December 2016. Data were analyzed from December 6, 2019, to July 15, 2020.ExposureAnnualized advertising spending for each hospital as measured by a market research firm.Main outcomes and measuresFour composites of hospital performance from the Centers for Medicare & Medicaid Services Hospital Compare database were used: risk-standardized mortality rate, risk-standardized readmission rate, Consumer Assessment of Healthcare Providers & Systems (CAHPS) Overall Patient Experience Rating (scale of 1-5; higher scores indicate a more positive patient experience rating), and overall 5-star rating. Linear models adjusted for hospital bed size, hospital revenue, and geographic census region.ResultsThe study sample included, on average, 4569 general acute care hospitals per year between 2008 and 2016. During this time, approximately half of acute care hospitals (2239 of 4569 [49%]) advertised their services to consumers and spent a total of $3.39 billion. Relative to hospitals that never advertised, advertising hospitals were more likely to be nonprofit facilities (mean [SD], 66% [47%] vs 51% [50%]; P < .001), had larger bed sizes (mean [SD], 234.3 [210.7] beds vs 84.8 [110.6] beds; P < .001), and had higher net incomes (mean [SD], $17 800 000 [$49 000 000] vs $134 099 [$51 600 000]; P < .001). There was no observed association between hospital advertising and performance. For example, hospitals that advertised had a mean (SD) CAHPS 5-star rating of 3.2 (0.9) stars compared with 3.3 (1.0) stars among hospitals that did not advertise, an insignificant difference (P = .92). We observed no difference in performance between advertising and nonadvertising hospitals in 30-day readmission rates (mean [SD], 15.5% [0.8%] vs 15.6% [1.0%]; P = .25), mortality rates (mean [SD], 12.7% [4.0%] vs 12.0% [4.1%]; P = .46), and overall 5-star hospital ratings (mean [SD], 3.1 [0.8] stars vs 3.0 [0.9] stars; P = .50). A significant difference was observed in adjusted mortality rates across terciles of advertising spending, with lower mortality rates for the hospitals with higher ad spending (2016, mean [SD] mortality composite for hospitals in the highest tercile, 11.2% [4.2%] vs hospitals in the middle tercile, 12.0% [3.8%], and for hospitals in the lowest tercile, 12.7% [4.1%]; P = .003).Conclusions and relevanceThe results of this cross-sectional study suggest that the amount hospitals spent on direct-to-consumer advertising was not associated with publicly reported measures of hospital quality; instead, hospital advertising spending was higher for financially stable hospitals with higher net incomes.

Project description:BACKGROUND:Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. METHODS:A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30th, 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS:A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (< 2 years and ≥ 65 years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION:Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.

Dataset Information

Prevalence of antibiotic use in a tertiary care hospital in Italy, 2008-2016.

Background

Methods

Results

Publications

Prevalence of antibiotic use in a tertiary care hospital in Italy, 2008-2016.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets