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Antibiotics 2017, 6(3), 19; doi:10.3390/antibiotics6030019

Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016

1
Center for Disease Dynamics, Economics & Policy, New Delhi 110020, India
2
Department of Infection Control & Microbiology, Amrita Institute of Medical Sciences, Amrita University, Ponekkara, Kochi 682041, India
3
Department of Infectious Diseases & Department of Paediatrics, Rural Development Trust Hospital, Bathalapalli 515661, India
4
Department of Paediatrics, Sowmya Children’s Hospital, Hyderabad 500038, India
5
Department of Paediatrics, Rural Development Trust Hospital, Kalyanadurgam 515761, India
6
Department of Microbiology & Department of Paediatric Intensive Care Unit, Fortis Hospital, Mohali 160062, India
7
Department of Paediatrics, Dr Yewale’s Multispeciality Hospital for Children, Navi Mumbai 400703, India
8
Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. Georges University, London SW17 0RE, UK
9
Department of Neonatology, Fernandez Hospital, Hyderabad 500029, India
10
Princeton Environmental Institute, Princeton University, Princeton, NJ 08544, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Christopher C. Butler
Received: 13 June 2017 / Revised: 22 August 2017 / Accepted: 7 September 2017 / Published: 13 September 2017
(This article belongs to the Special Issue Surveillance of Antimicrobial Use and Resistance in Children)
View Full-Text   |   Download PDF [344 KB, uploaded 13 September 2017]   |  

Abstract

The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) project, we examined the prevalence of and indications of antimicrobial use, as well as antimicrobial agents used among hospitalized children by conducting four point prevalence surveys in six hospitals between February 2016 and February 2017. A total of 681 children were hospitalized in six hospitals across all survey days, and 419 (61.5%) were prescribed one or more antimicrobials (antibacterials, antivirals, antifungals). Antibacterial agents accounted for 90.8% (547/602) of the total antimicrobial prescriptions, of which third-generation cephalosporins (3GCs) accounted for 38.9% (213/547) and penicillin plus enzyme inhibitor combinations accounted for 14.4% (79/547). Lower respiratory tract infection (LRTI) was the most common indication for prescribing antimicrobials (149 prescriptions; 24.8%). Although national guidelines recommend the use of penicillin and combinations as first-line agents for LRTI, 3GCs were the most commonly prescribed antibacterial agents (55/149 LRTI prescriptions; 36.9%). In conclusion, 61.5% of hospitalized children were on at least one antimicrobial agent, with excessive use of 3GCs. Hence there is an opportunity to limit their inappropriate use. View Full-Text
Keywords: point prevalence survey; antimicrobial use; children; hospital; India point prevalence survey; antimicrobial use; children; hospital; India
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Gandra, S.; Singh, S.K.; Jinka, D.R.; Kanithi, R.; Chikkappa, A.K.; Sharma, A.; Dharmapalan, D.; Vasudevan, A.K.; Tunga, O.; Akula, A.; Garg, G.; Hsia, Y.; Murki, S.; Alvarez-Uria, G.; Sharland, M.; Laxminarayan, R. Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016. Antibiotics 2017, 6, 19.

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