Document Type
Article
Publication Date
5-2022
Identifier
DOI: 10.1017/ash.2022.221; PMCID: PMC9726562
Abstract
OBJECTIVE: We examined ampicillin dosing in pediatric patients across 3 conditions: (1) bacterial lower respiratory tract infections (LRTIs) in infants and children >3 months, (2) neonates with suspected or proven sepsis, and (3) neonates with suspected central nervous system (CNS) infections. We compared our findings to dosing guidance for these specific indications.
DESIGN: Retrospective cohort study.
SETTING: The study included data from 32 children's hospitals in the United States.
METHODS: We reviewed prescriptions from the SHARPS study of antimicrobials, a survey of antibiotic prescribing from July 2016 to December 2017. Prescriptions were analyzed for indication, total daily dose per kilogram, and presence of antimicrobial stewardship program (ASP) review. LRTI prescriptions were compared to IDSA recommendations for community-acquired pneumonia. Neonatal prescriptions were compared to recommendations from the American Academy of Pediatrics (AAP). Prescriptions were categorized as "optimal" (80%-120% of recommended dosing), "suboptimal" (120% of recommended dosing).
RESULTS: Among 1,038 ampicillin prescriptions, we analyzed 88 prescriptions for LRTI, 499 prescriptions for neonatal sepsis, and 27 prescriptions for neonatal CNS infection. Of the LRTI prescriptions, 77.3%were optimal. Of prescriptions for neonatal sepsis, 81.6% were excessive compared to AAP bacteremia recommendations but 78.8% were suboptimal compared to AAP meningitis guidelines. Also, 48.1% of prescriptions for neonatal CNS infection were suboptimal, and 50.6% of prescriptions were not reviewed by the ASP.
CONCLUSIONS: LRTI dosing is generally within the IDSA-recommended range. However, dosing for neonatal sepsis often exceeds the recommendation for bacteremia but is below the recommendation for meningitis. This variability points to an important opportunity for future antimicrobial stewardship efforts.
Journal Title
Antimicrob Steward Healthc Epidemiol
Volume
2
Issue
1
First Page
85
Last Page
85
PubMed ID
36483411
Recommended Citation
Daniels EA, McPherson CC, Newland JG, Lee BR. Variation in ampicillin dosing for lower respiratory tract infections and neonatal bacterial infections in US children's hospitals. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e85. Published 2022 May 23. doi:10.1017/ash.2022.221
Comments
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Publisher's Link: https://doi.org/10.1017/ash.2022.221