%0 Journal Article %T Carbapenem prescriptions: Compliance with guidelines in a pediatric hospital. %A Cebron C %A Smiljkovic M %A Percheron L %A Caspar Y %A Arata-Bardet J %A Mortamet G %A Martinod M %J Arch Pediatr %V 30 %N 5 %D 2023 Jul 5 %M 37286425 %F 1.82 %R 10.1016/j.arcped.2023.05.001 %X 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.