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DI-100 Comparison of antibiotic prescribing for paediatric lower respiratory tract infections in three paediatric hospitals in the UK, France and Latvia
  1. I Sviestina1,
  2. J Aston2,
  3. M Lorrot3,
  4. S Prot-Labarthe4,
  5. F Angoulvant5,
  6. C Doit6,
  7. D Mozgis7
  1. 1Children Hospital/Riga Stradins University, Pharmacy Department, Riga, Latvia
  2. 2Birmingham Children’s Hospital, Pharmacy Department, Birmingham, UK
  3. 3Univ Paris Diderot Sordonne Paris Cité Hôpital Robert Debré AP-HP, Unité d’Épidémiologie Clinique INSERM CIE5 General Paediatric Unit, Paris, France
  4. 4Hôpital Robert-Debré AP-HP, Pharmacy Department, Paris, France
  5. 5Hôpital Robert-Debré AP-HP, Pediatric Emergency Unit, Paris, France
  6. 6Hôpital Robert-Debré AP-HP, Microbiology Department, Paris, France
  7. 7Riga Stradins University, Public Health and Epidemiology Department, Riga, Latvia

Abstract

Background The most common indications for antibiotic use in hospitalised children are lower respiratory tract infections (LRTI). The point prevalence survey (PPS) allows targets to be identified for quality improvement. Comparing antibiotic use between different countries may help identify successful initiatives that further rationalise treatment.

Purpose To compare antibiotic use for LRTI between three paediatric centres in the UK, France and Latvia to identify strategies to optimise treatment.

Materials and methods This PPS was a part of the Antibiotic Resistance and Prescribing in European Children project (ARPEC). It was conducted at three tertiary-care children’s hospitals in Birmingham (UK), Paris (France) and Riga (Latvia) using ARPEC methodology during November 2012.

Results LRTI accounted for 19/211 (9.0%) of antibiotic prescriptions in Birmingham, 29/245 (11.8%) in Paris and 43/168 (26%) in Riga. The most common age group of patients with LRTI across all three sites was under 5 years making up 14/19 (74%) patients in Birmingham, 14/29 (48%) in Paris and 22/39 (56%) in Riga. 7 different antibiotics were prescribed for LRTI in Birmingham, 14 in Paris and 9 in Riga. The most commonly prescribed antibiotics were co- amoxicillin/clavulanic acid 5 (28% of prescriptions) and piperacillin/tazobactam 5 (28%) in Birmingham, amoxicillin 5 (17%) and amoxicillin/clavulanic acid 6 (21%) in Paris and, amoxicillin 13 (30%) and ceftriaxone 9 (21%) in Riga. In Birmingham 13 (68%) antibiotic prescriptions were for community acquired infections, in Paris 24 (83%) and 42 (98%) in Riga. Antibiotics were predominantly prescribed intravenously: 11 (58%) prescriptions in Birmingham, 16 (55%) in Paris and 36 (84%) in Riga.

Conclusions The PPS identified differences in antibiotic use in 3 hospitals and the high use of parenteral antibiotics in all hospitals. Further studies are required to determine the appropriateness of the choice of antibiotics in LRTI, the diversity of agents prescribed and the use of broad-spectrum antibiotic treatment.

No conflict of interest.

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