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Multicenter Study
. 2020 Feb;39(2):249-255.
doi: 10.1007/s10096-019-03714-9. Epub 2019 Oct 31.

Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil

André Ricardo Araujo da Silva  1 , Elena Jaszkowski  2 , Tilmann Schober  2 , Ulrich von Both  2 , Melanie Meyer-Buehn  2 , Amanda Fáris Marques  3 , Beatriz Farkas  3 , Bernardo Silva de Abreu  3 , Clara Biscaia di Biase  3 , Jully Miyoshi Takahashi  3 , Luisa Dutra de Castro  3 , Izabel Alves Leal  3 , Cristiane Henriques Teixeira  3 , Claudia Franziska Nussbaum  4 , Florian Hoffmann  5 , Johannes Hübner  2
Affiliations
Multicenter Study

Patterns of antimicrobial consumption in neonatal and pediatric intensive care units in Germany and Brazil

André Ricardo Araujo da Silva et al. Eur J Clin Microbiol Infect Dis. 2020 Feb.

Abstract

Antibiotic consumption (AC) is a key component of antimicrobial stewardship programs to recognize local patterns of antibiotic use. Our aim was to measure AC in neonatal units, including neonatal (NICU)/paediatric (PICU) intensive care units in different countries. We conducted a multicenter, retrospective, cohort study in three NICUs, one neonatal ward, and three PICUs with a total of 84 beds. Global and individual AC in days of therapy (DOT) and DOT per 1000 patient-days were assessed. During the study period, 2567 patients were admitted, corresponding to 4961 patient-days in neonatal units and 9243 patient-days in PICUs. Multidrug-resistant Gram-negative bacteria and methicillin-resistant Staphylococcus aureus were more frequent in Brazil than in Germany. Average AC was 386.5 and 1335.5 DOT/1000PD in German and Brazilian neonatal units, respectively. Aminopenicillins plus 3rd generation cephalosporins were the most commonly prescribed antibiotics in German neonatal units, while aminopenicillins plus aminoglycosides were the class most commonly used in Brazilian NICU. Average AC was 888.1 and 1440.7 DOT/1000PD in German and Brazilian PICUs, respectively. Antipseudomonal penicillins were most commonly used in the German PICU, and glycopeptides were the most frequently prescribed in Brazilian PICUs. Carbapenems represented 2.3-14% of total DOTs in German neonatal units and 4% in the Brazilian NICU and 13.0% in the German PICU and 6-12.2% in Brazilian PICUs. We concluded that different patterns of most commonly prescribed antibiotics were observed in neonatal units and PICUs in these two countries, probably related to different local patterns of antibiotic resistance, with a higher antibiotic consumption in Brazilian study units.

Keywords: Antimicrobial consumption; Neonatal intensive care unit; Paediatric intensive care unit.

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References

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