Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings
Antimicrobial resistance (AMR) poses a global threat, partly fueled by antimicrobial overuse. Paediatric inpatients are particularly vulnerable to infections, leading to high antimicrobial consumption. In low-to-middle income countries (LMICs) like South Africa, research on antimicrobial usage for...
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South African Medical Association
2024-04-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1296 |
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| author | J Cloete M Karsas T Chetty A Pillay M Archary D Moore T Reddy Y Balakrishna F Nakwa R Lancaster A Goga P Jeena |
| author_facet | J Cloete M Karsas T Chetty A Pillay M Archary D Moore T Reddy Y Balakrishna F Nakwa R Lancaster A Goga P Jeena |
| author_sort | J Cloete |
| collection | DOAJ |
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Antimicrobial resistance (AMR) poses a global threat, partly fueled by antimicrobial overuse. Paediatric inpatients are particularly vulnerable to infections, leading to high antimicrobial consumption. In low-to-middle income countries (LMICs) like South Africa, research on antimicrobial usage for neonatal and paediatric healthcare-associated infections (HAI) is limited. This cross-sectional study evaluated antimicrobial usage in three academic public sector hospitals in South Africa to improve appropriateness. 22.9% of hospitalised children received at least one prescribed antimicrobial, with neonates, infants, and adolescents having higher prescription rates for HAIs. Common antimicrobials prescribed included beta-lactamase sensitive penicillin, aminoglycosides, and carbapenems. Antimicrobial selection aligned with the WHO AWaRe classification system. HIV infection did not emerge as a risk factor for HAIs or excessive antimicrobial usage. The policy brief recommends several strategies, summarized by the acronym 'PRACTICE,' to optimize antimicrobial prescribing practices. These include implementing standardized policies for empiric antimicrobial use, routine review of antimicrobial therapy, age-specific antimicrobial stewardship programs, and continued collaborative efforts and research. Individualized treatment plans, improved infection prevention and control measures, ongoing surveillance, and exploring electronic technology for antimicrobial stewardship are also crucial. Addressing antimicrobial usage is imperative to combat the growing threat of AMR and improve patient outcomes in LMICs like South Africa.
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| format | Article |
| id | doaj-art-c10d251d87b248c7a03708f1fa641bab |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-c10d251d87b248c7a03708f1fa641bab2025-02-10T12:26:19ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-04-01114410.7196/SAMJ.2024.v114i4.1296Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settingsJ Cloete0M Karsas1T Chetty2A Pillay3M Archary4D Moore5T Reddy6Y Balakrishna7F Nakwa8R Lancaster9A Goga10P Jeena11Department of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa and Maternal and Infant Health Care Strategies Research Unit Centre, University of Pretoria, Pretoria, South AfricaDepartment of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa; and Maternal and Infant Health Care Strategies Research Unit Centre, University of Pretoria, South AfricaHIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa. Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South AfricaDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South AfricaDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South AfricaDepartment of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; South African Medical Research Council Vaccine and Infectious Diseases Analytics (VIDA) Research Unit, University of the Witwatersrand, Johannesburg, South AfricaBiostatistics Research Unit, South African Medical Research Council, Durban, South Africa; School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South AfricaBiostatistics Research Unit, South African Medical Research Council, Durban, South AfricaDepartment of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaAffordable Medicines Directorate, National Department of Health, Pretoria, South AfricaHIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa; Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South AfricaDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa; Department of Paediatrics and Child Health, Inkosi Albert Luthuli Central Hospital, Durban, South Africa Antimicrobial resistance (AMR) poses a global threat, partly fueled by antimicrobial overuse. Paediatric inpatients are particularly vulnerable to infections, leading to high antimicrobial consumption. In low-to-middle income countries (LMICs) like South Africa, research on antimicrobial usage for neonatal and paediatric healthcare-associated infections (HAI) is limited. This cross-sectional study evaluated antimicrobial usage in three academic public sector hospitals in South Africa to improve appropriateness. 22.9% of hospitalised children received at least one prescribed antimicrobial, with neonates, infants, and adolescents having higher prescription rates for HAIs. Common antimicrobials prescribed included beta-lactamase sensitive penicillin, aminoglycosides, and carbapenems. Antimicrobial selection aligned with the WHO AWaRe classification system. HIV infection did not emerge as a risk factor for HAIs or excessive antimicrobial usage. The policy brief recommends several strategies, summarized by the acronym 'PRACTICE,' to optimize antimicrobial prescribing practices. These include implementing standardized policies for empiric antimicrobial use, routine review of antimicrobial therapy, age-specific antimicrobial stewardship programs, and continued collaborative efforts and research. Individualized treatment plans, improved infection prevention and control measures, ongoing surveillance, and exploring electronic technology for antimicrobial stewardship are also crucial. Addressing antimicrobial usage is imperative to combat the growing threat of AMR and improve patient outcomes in LMICs like South Africa. https://samajournals.co.za/index.php/samj/article/view/1296Antimicrobial usehospital acquired infectionpaediatric antimicrobial usepaediatric hospital acquired infectionantimicrobial resistancepaediatric antimicrobial resistance |
| spellingShingle | J Cloete M Karsas T Chetty A Pillay M Archary D Moore T Reddy Y Balakrishna F Nakwa R Lancaster A Goga P Jeena Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings South African Medical Journal Antimicrobial use hospital acquired infection paediatric antimicrobial use paediatric hospital acquired infection antimicrobial resistance paediatric antimicrobial resistance |
| title | Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings |
| title_full | Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings |
| title_fullStr | Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings |
| title_full_unstemmed | Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings |
| title_short | Policy brief: Optimising antimicrobial usage in paediatric inpatient hospital settings |
| title_sort | policy brief optimising antimicrobial usage in paediatric inpatient hospital settings |
| topic | Antimicrobial use hospital acquired infection paediatric antimicrobial use paediatric hospital acquired infection antimicrobial resistance paediatric antimicrobial resistance |
| url | https://samajournals.co.za/index.php/samj/article/view/1296 |
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