Antibiotic Surveillance in the Pediatric Intensive Care Unit (Picu) at Sanglah Hospital Denpasar 2015 – 2017



Dyah Kanya Wati1, *, I Wayan Gustawan1, Ni Nengah Dwi Fatmawati2, I Ketut Tunas3, Putu Andrie Setiawan4
1 Department of Child Health, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali80114, Indonesia
2 Department of Clinical Microbiology, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali80114, Indonesia
3 Public Health Dhyana Pura University, Denpasar, Bali80361, Indonesia
4 Udayana University Medical School, Denpasar, Bali80225, Indonesia

Abstract

Background:

Antibiotic surveillance in hospital settings is mandatory for optimal antibiotic therapy for the patient. Only a small number of studies have focused on antibiotic surveillance in hospitalized newborns, infants, and children.

Objectives:

The goal was to evaluate antibiotic use in our pediatric intensive care unit (PICU) and evaluate it for a possible association with the length of PICU stay.

Methods:

A retrospective, observational, cohort study was conducted from January 2015 to April 2017, involving subjects who were hospitalized in the PICU at Sanglah Hospital. The inclusion criteria were children aged between 1-month–12-years old, who had a blood culture and antibiotic sensitivity test result in their medical record. The exclusion criteria were incomplete medical records, blood cultures showing 2 types of bacteria at the same time (gram-positive and negative), or contaminated blood results. Factors associated with mortality were analyzed using a Chi-square test, with p < 0.05 considered to be statistically significant and the risk ratio (RR) of the associated factors was determined by 95% CI.

Results:

Multivariate analysis showed that the significant predictors of PICU length of stay were the appropriate continuation of antibiotics (RR 1.19; 95% CI 1.043 to 1.373; P = 0.047). There were also significant results for antibiotic compatibility and length of stay (RR 3.6; 95% CI 0.869 to 15.428; P = 0.049).

Conclusion:

Appropriate continuation of antibiotics and the compatibility of continuation antibiotics were significant predictors of length of PICU stay based on multivariate analysis.

Keywords: Antibiotic, Sensitivity, Resistance, Surveillance, Children, PICU.


Abstract Information


Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOMICROJ-2018-44

Article History:

Received Date: 28/11/2018
Revision Received Date: 03/03/2019
Acceptance Date: 10/03/2019
Electronic publication date: 09/04/2019
Collection year: 2019

© 2019 Wati et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Correspondence: Address correspondence to this author at the Department of Child Health, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali, Indonesia; Tel: +6281285705152; Fax: 0361244038; E-mail: dyahpediatric@yahoo.com