@article{3184189,
    title = "High Rates of Prescribing Antimicrobials for Prophylaxis in Children and
Neonates: Results From the Antibiotic Resistance and Prescribing in
European Children Point Prevalence Survey",
    author = "Hufnagel, Markus and Versporten, Ann and Bielicki, Julia and Drapier, and Nico and Sherland, Mike and Goossens, Herman and Maria Calle, Graciela and and Clark, Julia and Cooper, Celia and Blyth, Christopher C. and and Francis, Joshua Reginald and Alsalman, Jameela and Jansen, Hilde and and Mahieu, Ludo and Van Rossom, Paul and Vandewal, Wouter and Lepage, and Philippe and Blumental, Sophie and Briquet, Caroline and Robbrecht, Dirk and and Maton, Pierre and Gabriels, Patrick and Rubic, Zana and Kovacevic, and Tanja and Nielsen, Jens Peter and Petersen, Jes Reinholdt and and Poorisrisak, Porntiva and Jensen, Lise Heilmann and Laan, Mari and Tamm, and Eda and Matsinen, Maire and Rummukainen, Maija-Liisa and Gajdos, Vincent and and Olivier, Romain and Le Marechal, Flore and Martinot, Alain and and Dubos, Francois and Lagree, Marion and Prot-Labarthe, Sonia and Lorrot, and Mathie and Orbach, Daniel and Pagava, Karaman and Knuf, Markus and and Schlag, Stephanie A. A. and Liese, Johannes and Renner, Lorna and and Enimil, Anthony and Awunyo, Marah and Syridou, Garyfallia and Spyridis, and Nikos and Critselis, Elena and Kouni, Sofia and Mougkou, Katerina and and Ladomenou, Fani and Gkentzi, Despoina and Iosifidis, Elias and Roilides, and Emmanuel and Sahu, Suneeta and Murki, Srinivas and Malviya, Manoj and and Kalavalapalli, Durga Bhavani and Singh, Sanjeev and Singhal, Tanu and and Garg, Garima and Garg, Pankaj and Kler, Neelam and Soltani, Jafar and and Jafarpour, Zahra and Pouladfar, Gholamreza and Nicolini, Giangiacomo and and Montagnani, Carlotta and Galli, Luisa and Esposito, Susanna and Tenconi, and Rossana and Lo Vecchio, Andrea and Dona, Daniele and Giaquinto, Carlo and and Borgia, Eleonora and D'Argenio, Patrizia and De Luca, Maia and and Centenari, Chiara and Raka, Lul and Raka, Denis and Omar, Abeer and and Al-Mousa, Haifaa and Mozgis, Dzintars and Sviestina, Inese and and Burokiene, Sigita and Usonis, Vytautas and Tavchioska, Gabriela and and Hargadon-Lowe, Antonia and Zarb, Peter and Borg, Michael A. and Gonzalez and Lozano, Carlos Agustin and Zarate Castanon, Patricia and Cancino, Martha and E. and McCullagh, Bernadette and McCorry, Ann and Gormley, Cairine and and Al Maskari, Zaina and Al-Jardani, Amina and Pluta, Magdalena and and Rodrigues, Fernanda and Brett, Ana and Esteves, Isabel and Marques, and Laura and AlAjmi, Jameela Ali and Cambrea, Simona Claudia and Rashed, and Asia N. and Al Azmi, Aeshah Abdu Mubarak and Chan, Si Min and Isa, Mas and Suhaila and Najdenov, Peter and Cizman, Milan and Unuk, Sibila and and Finlayson, Heather and Dramowski, Angela and Mate-Cano, Irene and Soto, and Beatriz and Calvo, Cristina and Santiago, Begona and Saavedra-Lozano, and Jesus and Bustinza, Amaya and Escosa-Garcia, Luis and Ureta, Noelia and and Lopez-Varela, Elisa and Rojo, Pablo and Tagarro, Alfredo and Terol and Barrero, Pedro and Maria Rincon-Lopez, Elena and Abubakar, Ismaela and and Aston, Jeff and Patel, Mitul and Russell, Alison Bedford and and Heginbothom, Maggie and Satodia, Prakash and Garbash, Mehdi and Johnson, and Alison and Sharpe, David and Barton, Christopher and Menson, Esse and and Arenas-Lopez, Sara and Luck, Suzanne and Doerholt, Katja and McMaster, and Paddy and Caldwell, Neil A. and Lunn, Andrew and Drysdale, Simon B. and and Howe, Rachel and Scorrer, Tim and Gahleitner, Florian and Gupta, Richa and and Nash, Clare and Alexander, John and Raman, Mala and Bell, Emily and and Rajagopal, Veena and Kohlhoff, Stephan and Cox, Elaine and Nichols, and Kristen and Zaoutis, Theoklis and ARPEC Project Grp",
    journal = "Journal of the Pediatric Infectious Diseases Society",
    year = "2019",
    volume = "8",
    number = "2",
    pages = "143-151",
    publisher = "Oxford University Press",
    issn = "2048-7193, 2048-7207",
    doi = "10.1093/jpids/piy019",
    keywords = "antimicrobials; inpatients; pediatrics; point-prevalence survey;
prophylactic prescribing",
    abstract = "Background. This study was conducted to assess the variation in
prescription practices for systemic antimicrobial agents used for
prophylaxis among pediatric patients hospitalized in 41 countries
worldwide.
Methods. Using the standardized Antibiotic Resistance and Prescribing in
European Children Point Prevalence Survey protocol, a cross-sectional
point-prevalence survey was conducted at 226 pediatric hospitals in 41
countries from October 1 to November 30, 2012.
Results. Overall, 17 693 pediatric patients were surveyed and 36.7% of
them received antibiotics (n = 6499). Of 6818 inpatient children, 2242
(32.9%) received at least 1 antimicrobial for prophylactic use. Of 11
899 prescriptions for antimicrobials, 3400 (28.6%) were provided for
prophylactic use. Prophylaxis for medical diseases was the indication in
73.4% of cases (2495 of 3400), whereas 26.6% of prescriptions were for
surgical diseases (905 of 3400). In approximately half the cases (48.7%
[1656 of 3400]), a combination of 2 or more antimicrobials was
prescribed. The use of broad-spectrum antibiotics (BSAs), which included
tetracyclines, macrolides, lincosamides, and sulfonamides/trimethoprim,
was high (51.8% [1761 of 3400]). Broad-spectrum antibiotic use for
medical prophylaxis was more common in Asia (risk ratio [RR], 1.322;
95% confidence interval [CI], 1.202-1.653) and more restricted in
Australia (RR, 0.619; 95% CI, 0.521-0.736). Prescription of BSA for
surgical prophylaxis also varied according to United Nations region.
Finally, a high percentage of surgical patients (79.7% [721 of 905])
received their prophylaxis for longer than 1 day.
Conclusions. A high proportion of hospitalized children received
prophylactic BSAs. This represents a clear target for quality
improvement. Collectively speaking, it is critical to reduce total
prophylactic prescribing, BSA use, and prolonged prescription."
}