Abstract：
BACKGROUND: This study aimed to describe the use of carbapenems in a pediatric tertiary center and to assess its compliance with national and local guidelines.
METHODS: This retrospective study focused on children who received at least one dose of carbapenems in a tertiary university hospital over a 1-year period (2019). The appropriateness of each prescription was assessed.
RESULTS: In total, 96 prescriptions were collected for 75 patients (median age 3 years [interquartile range, IQR: 0-9]). Most prescriptions were empirical (n = 77, 80%) and mainly concerned nosocomial infections (n = 69, 72%). At least one risk factor for extended-spectrum beta-lactamases was found in 48% (n = 46) of cases. The median duration of treatment with carbapenems was 5 days and it was over 7 days in 38% (n = 36) of cases. The use of carbapenems was considered appropriate in 95% (18/19) and 70% (54/77) of cases when therapy was guided by culture results or was empirical, respectively. De-escalation of carbapenem treatment within 72 h occurred in 31% (n = 30) of cases.
CONCLUSIONS: The use of carbapenems can be optimized in the pediatric population, even when the initial prescription for a carbapenem is considered appropriate.
METHODS: This retrospective study focused on children who received at least one dose of carbapenems in a tertiary university hospital over a 1-year period (2019). The appropriateness of each prescription was assessed.
RESULTS: In total, 96 prescriptions were collected for 75 patients (median age 3 years [interquartile range, IQR: 0-9]). Most prescriptions were empirical (n = 77, 80%) and mainly concerned nosocomial infections (n = 69, 72%). At least one risk factor for extended-spectrum beta-lactamases was found in 48% (n = 46) of cases. The median duration of treatment with carbapenems was 5 days and it was over 7 days in 38% (n = 36) of cases. The use of carbapenems was considered appropriate in 95% (18/19) and 70% (54/77) of cases when therapy was guided by culture results or was empirical, respectively. De-escalation of carbapenem treatment within 72 h occurred in 31% (n = 30) of cases.
CONCLUSIONS: The use of carbapenems can be optimized in the pediatric population, even when the initial prescription for a carbapenem is considered appropriate.
摘要：
背景：本研究旨在描述碳青霉烯类在儿科三级中心的使用情况，并评估其对国家和地方指南的依从性。
方法：这项回顾性研究的重点是在1年内（2019年）在三级大学医院接受至少一剂碳青霉烯类抗生素治疗的儿童。评估每个处方的适当性。
结果：总计，收集了75例患者的96份处方(中位年龄3岁[四分位距，IQR：0-9]）。大多数处方是经验性的（n=77，80％），主要涉及医院感染（n=69，72％）。在48％（n=46）的病例中发现了至少一种超广谱β-内酰胺酶的危险因素。38％（n=36）的碳青霉烯类抗生素治疗的中位持续时间为5天，超过7天。95％（18/19）和70％（54/77）的病例中，碳青霉烯类抗生素的使用被认为是适当的，分别。31％（n=30）的病例在72小时内使用碳青霉烯治疗。
结论：在儿科人群中可以优化碳青霉烯类抗生素的使用，即使碳青霉烯的初始处方被认为是合适的。
方法：这项回顾性研究的重点是在1年内（2019年）在三级大学医院接受至少一剂碳青霉烯类抗生素治疗的儿童。评估每个处方的适当性。
结果：总计，收集了75例患者的96份处方(中位年龄3岁[四分位距，IQR：0-9]）。大多数处方是经验性的（n=77，80％），主要涉及医院感染（n=69，72％）。在48％（n=46）的病例中发现了至少一种超广谱β-内酰胺酶的危险因素。38％（n=36）的碳青霉烯类抗生素治疗的中位持续时间为5天，超过7天。95％（18/19）和70％（54/77）的病例中，碳青霉烯类抗生素的使用被认为是适当的，分别。31％（n=30）的病例在72小时内使用碳青霉烯治疗。
结论：在儿科人群中可以优化碳青霉烯类抗生素的使用，即使碳青霉烯的初始处方被认为是合适的。
