Evgenia Papakonstantinou (Greece)
Hippokration Hospital of Thessaloniki Pediatric Oncology DepartmentAuthor Of 1 Presentation
PATTERNS AND TRENDS OF ANTIBACTERIAL AND ANTIFUNGAL USE IN A PEDIATRIC ONCOLOGY DEPARTMENT
Abstract
Backgrounds:
Monitoring of antibacterial and antifungal use is essential for antimicrobial stewardship strategies. We studied patterns and time trends of antibacterial and antifungal use in a pediatric oncology department.
Methods
A retrospective analysis of monthly antibacterial and antifungal use was conducted in a 20-bed pediatric oncology department of a tertiary-level hospital from January 2018 to May 2020 (29 months). Data of antimicrobial and antifungal consumption was obtained from the hospital pharmacy and expressed as defined daily doses per 100 bed-days (DDD/100BD). Number of bed-days was obtained from Hospital Office of Statistics.
Results:
During study period there was a median monthly rate of 301 bed-days. Total consumption of antibacterials had a median monthly rate of 108 DDD/100BD and of antifungals 94 DDD/100BD showing significant increases (p=0.015 and p<0.001, respectively). Glycopeptides (vancomycin/teicoplanin) constituted the most common used antibacterial class (29.5 DDD/100BD). Carbapenems were the second most used antibacterial agents (15.2 DDD/100BD) with a significant increase (p=0.009). Consumption of aminoglycosides and combination of piperacillin with tazobactam followed with 13.8 DDD/100BD and 11.7 DDD/100BD, respectively. Consumption of cotrimoxazole was 9.3 DDD/100BD, followed by metronidazole (6.4 DDD/100BD), colistin (4 DDD/100BD) and quinolones (3.8 DDD/100BD). Utilization of 3rd generation cephalosporins was relatively low (3.7 DDD/100BD). Voriconazole constituted the most common used antifungal agent (45 DOT/100BD). Micafungin was the second most commonly used antifungal agent (18 DOT/100BD) with a significant increase (p=0.028).
Conclusions/Learning Points:
High consumption of glycopeptides and carbapenems combined by constant use of colistin is of concern. Emergence of antimicrobial resistance in pediatric oncology patients could explain this pattern. High voriconazole and micafungin use mainly reflects antifungal prophylaxis practices. These results may guide antimicrobial and antifungal stewardship activities.
Poster Author Of 2 e-Posters
EP371 - CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSIS) IN PEDIATRIC ONCOLOGY PATIENTS (ID 1533)
