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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 26 (2015), Issue 5, Pages 253-258
http://dx.doi.org/10.1155/2015/835209
Original Article

Antimicrobial Use Over a Four-Year Period Using Days of Therapy Measurement at a Canadian Pediatric Acute Care Hospital

Bruce R Dalton,1,2 Sandra J MacTavish,1,3 Lauren C Bresee,1,3,4 Nipunie Rajapakse,5,6,7 Otto Vanderkooi,5,6,7 Joseph Vayalumkal,5,6,7 and John Conly7,8,9,10

1Department of Pharmacy Services, Alberta Health Services, Calgary, Canada
2O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
3School of Pharmacy, University of Waterloo, Waterloo, Ontario, canada
4Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
5Department of Pediatrics, Section of Infectious Diseases, University of Calgary, Canada
6Department of Medicine, Cumming School of Medicine, University of Calgary, Canada
7Alberta Children’s Hospital Research Institute, Alberta Health Services, University of Calgary, Calgary, Alberta, Canada
8Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
9Synder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
10Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Antimicrobial resistance is a concern that is challenging the ability to treat common infections. Surveillance of antimicrobial use in pediatric acute care institutions is complicated because the common metric unit, the defined daily dose, is problematic for this population.

OBJECTIVE: During a four-year period in which no specific antimicrobial stewardship initiatives were conducted, pediatric antimicrobial use was quantified using days of therapy (DOT) per 100 patient days (PD) (DOT/100 PD) at the Alberta Children’s Hospital (Calgary, Alberta) for benchmarking purposes.

METHODS: Drug use data for systemic antimicrobials administered on wards at the Alberta Children’s Hospital were collected from electronic medication administration records. DOT were calculated and rates were determined using 100 PD as the denominator. Changes over the surveillance period and subgroup proportions were represented graphically and assessed using linear regression.

RESULTS: Total antimicrobial use decreased from 93.6 DOT/100 PD to 75.7 DOT/100 PD (19.1%) over the 2010/2011 through to the 2013/2014 fiscal years. During this period, a 20.0% increase in PD and an essentially stable absolute count of DOT (2.9% decrease) were observed. Overall, antimicrobial use was highest in the pediatric intensive care and oncology units.

DISCUSSION: The exact changes in prescribing patterns that led to the observed reduction in DOT/100 PD with associated increased PD are unclear, but may be a topic for future investigations.

CONCLUSION: Antimicrobial use data from a Canadian acute care pediatric hospital reported in DOT/100 PD were compiled for a four-year time period. These data may be useful for benchmarking purposes.