engleski

Antimicrobial Prescribing in hospitalized Pediatric Patients: A cross-national comparisson between Marburg (Germany) and Rijeka (Croatia)

Background: Antibiotics represent the most commonly used drugs in the pharmacological treatment of children and adolescents. However, knowledge about patterns of antibiotic utilisation in children remains sparse throughout Europe. Objectives: To compare the utilisation of systemic antibiotics in the pediatric inpatient setting between two university hospitals in Germany and Croatia. Methods: We analysed antibiotic drug treatment among inpatients 18 years that were consecutively admitted to the University hospitals of Marburg (Germany) and Rijeka (Croatia) as from January 2003. In each center, 300 incident users of systemic antibiotics were included. Data retrieval was based on information from the medical charts by means of a standardized questionnaire addressing indication, symptoms, and treatment characteristics. Antibiotic utilisation was evaluated with respect to drug choice, treatment duration, and administered dose. Each drug was classified to the 5th level of the Anatomical Therapeutic Chemical (ATC) classification system. We also assessed the extent of antibiotic treatment verified by pathogen identification or susceptibility test. Results: In both centers, more than ⅓ of patients were younger than 1 year and an even gender distribution was observed. In Marburg, we identified 21 different antibiotic generics as opposed to 30 in Rijeka. Ampicillin (J01CA01) and cefuroxime (J01DA06) were most frequently used in Marburg each drug constituting about ⅓ of all antibiotic courses. In Rijeka, ceftriaxone (J01DA13) was most commonly used accounting for more than of all antibiotic courses, whereas it was seldomly prescribed in Marburg. In both centers, pneumonia was the most common indication. More than 75 % of antibiotic treatment courses were initiated empirically based on clinical symptoms without any pathogen identification or susceptibility test. Conclusions: Despite similar study population characteristics, a greatly different antibiotic utilisation profile was observed in Marburg (Germany) and Rijeka (Croatia). A further evaluation of drug choice determinants and of the quality of prescribing are warranted.

antibiotics; children

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