One-quarter of kids who receive antibiotics in US children's hospitals are given the drugs inappropriately, which increases the risk of antibiotic resistance, researchers say.
"Antibiotic resistance is a growing danger to everyone; however, there is limited data on children," said study co-author Dr Jason Newland, a professor of paediatrics at Washington University in St. Louis.
"Data on adults have suggested that 30%-50% of antibiotics used in hospitalized adults are inappropriate," Newland noted in a university news release.
He said the goal of the study was to determine if antibiotics used to treat hospitalised children were "suboptimal". That means doctors shouldn't have prescribed any antibiotics; they could have used a more effective antibiotic; or they could have prescribed a different dose or for a shorter duration.
"Health care workers must be vigilant since the inappropriate use of antibiotics is fuelling dangerous drug resistance in children," explained Newland, who directs the antimicrobial stewardship program at St. Louis Children's Hospital.
About one in three patients in US children's hospitals receives one or more antibiotics, the researchers said in background notes.
They analysed data from nearly 12 000 patients at 32 US children's hospitals. The kids were prescribed one or more antibiotics to treat or prevent infections. Of those patients, 25% – or nearly 3,600– received at least one antibiotic considered inappropriate, according to the study.
The most common cases of inappropriate antibiotic use were: giving the wrong antibiotic for a particular infection (27%); prolonged antibiotic use after surgery to prevent surgical-site infections (17%); unnecessary use of antibiotics (11%); and use of broad-spectrum antibiotics when a drug that targets a specific type of bacteria could have been used (11%).
Significant need for oversight
Pneumonia, or lower respiratory infections, accounted for the greatest percentage of suboptimal prescriptions – 18%.
The researchers also found that about half of inappropriate antibiotic use would not have been detected by current antibiotic stewardship programmes designed to prevent antibiotic resistance.
"Arguably, this is one of the most important findings because it helps us to identify blind spots in antimicrobial stewardship programmes," Newland said.
"Antibiotics currently not targeted for review still have a significant need for oversight. The obvious solution is to expand routine reviews to include all antibiotics. Unfortunately, this is resource-intensive and may not be feasible at some hospitals," he pointed out.
The study was recently published online in the journal Clinical Infectious Diseases.