Antimicrobial stewardship practice and metrics use to assess antibiotic consumption in paediatric ward: A national survey

Abstract

Background

Antibiotics are widely prescribed therapeutic agents in the paediatric population.

Aim/objective

This survey aims to describe an overview of antimicrobial stewardship (AMS) and the type of metrics used to monitor antibiotic consumption in paediatric wards in Malaysian public hospitals.

Methods

This research was conducted as a multicentre, quantitative research online survey in all Ministry of Health Malaysia hospitals with paediatric ward services. The survey respondents were the pharmacists in charge of either a paediatric ward or antibiotic consumption in each facility.

Results

Out of the 145 hospitals, only 99 with eligible facilities were shortlisted for the survey. Of the 99 hospitals identified in this survey, only 91 of the facilities responded. The result from the survey revealed that only six hospitals had a paediatric infectious disease (ID) specialist. Only 26 out of the 91 facilities that responded performed paediatric antibiotic monitoring. The survey showed that the type of metrics used to monitor antibiotic consumption varied. 46.2% (12/26) of paediatric monitored facilities were using defined daily dose (DDD), 23.1% (6/26) using days of therapy, 19.2% (5/26) using the number of vials, 15.4% (4/26) using the number of patients and 11.5% (3/26) using the length of therapy as their consumption metrics. Half (50%, 13/26) of the paediatric monitored facilities did not use any denominator for reporting while some facilities (38.5%, 10/26) used patient days.

Conclusion

Although 90% of the facilities practice AMS, in paediatrics, there appears to be no standardisation especially in antimicrobial consumption monitoring.