EP033 - PATTERNS AND TRENDS OF ANTIMICROBIAL USE IN A PEDIATRIC INTENSIVE CARE UNIT (PICU) USING DAYS OF THERAPY (ID 1064)
Abstract
Backgrounds:
Monitoring of antimicrobial use is essential for antimicrobial stewardship programs. We studied pattern and time trends of antimicrobial use in PICU.
Methods
A retrospective analysis of monthly antimicrobial use at a patient-level was conducted in an 8-bed polyvalent PICU of a tertiary-level hospital from June 2018 to December 2019. Days of Therapy (DOT) of each antimicrobial agent/category divided by 100 bed-days (DOT/100BD) was used.
Results:
During study period there were 178 admissions and a median monthly rate (MR) of 181 bed-days. Total consumption of antimicrobials had a median monthly rate (MMR) 259 DOTs/100BD. Glycopeptides (vancomycin/teicoplanin) constituted the most common used antimicrobial class (40 DOT/100BD) but showed a significant decrease during the last 4 months of the study. Cephalosporins were the second most used antimicrobial class (32 DOT/100BD) with 3rd generation cephalosporins (GC) being the most prevalent (26 DOT/100BD). Use of 2nd GC and 4th GC was low (1 and 2DOT/100BD, respectively). Consumption of both ceftazidime/avibactam and ceftolozane/tazobactam was documented only for 2 months during the study period (MMR 7 and 9 DOT/100BD, respectively). Utilization of aminoglycosides had a MMR 29 DOT/100BD. Carbapenems (mainly meropenem), colistin and piperacillin/tazobactam (the most used penicillin) had a MMR 27, 18 and 12 DOT/100BD, respectively. Metronidazole and clindamycin had a MMR 23 DOT/100BD and 9 DOT/100BD, respectively. Use of other antimicrobials included macrolides, ciprofloxacin and co-trimoxazole with a MMR of 14, 14 and 3 DOT/100BD, respectively. Linezolid use was infrequent whereas tigecycline was used at a MMR of 3.7 DOT/100BD.
Conclusions/Learning Points:
High prevalence of antimicrobials use, relatively high utilization of colistin and constant use of tigecycline is of concern and may reflect emergence of multidrug resistant bacteria.
