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Considerable variability in antibiotic use among US children’s hospitals in 2017–2018

Published online by Cambridge University Press:  06 March 2020

Hannah G. Griffith Open the ORCID record for Hannah G. Griffith [Opens in a new window] ,
Keerti Dantuluri Open the ORCID record for Keerti Dantuluri [Opens in a new window] ,
Cary Thurm ,
Derek J. Williams ,
Ritu Banerjee ,
Leigh M. Howard  and
Carlos G. Grijalva
Hannah G. Griffith*
Affiliation:
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
Keerti Dantuluri
Affiliation:
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Cary Thurm
Affiliation:
Children’s Hospital Association, Overland Park, Kansas City, Kansas
Derek J. Williams
Affiliation:
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Ritu Banerjee
Affiliation:
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Leigh M. Howard
Affiliation:
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
Carlos G. Grijalva
Affiliation:
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
*
Author for correspondence: Hannah G. Griffith, E-mail: hannah.griffith.1@vumc.org
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Abstract

Objective:

To characterize the prevalence of and seasonal and regional variation in inpatient antibiotic use among hospitalized US children in 2017–2018.

Design:

We conducted a cross-sectional examination of hospitalized children. The assessments were conducted on a single day in spring (May 3, 2017), summer (August 2, 2017), fall (October 25, 2017), and winter (January 31, 2018). The main outcome of interest was receipt of an antibiotic on the study day.

Setting:

The study included 51 freestanding US children’s hospitals that participate in the Pediatric Health Information System (PHIS).

Patients:

This study included all patients <18 years old who were admitted to a participating PHIS hospital, excluding patients who were admitted solely for research purposes.

Results:

Of 52,769 total hospitalized children, 19,174 (36.3%) received antibiotics on the study day and 6,575 of these (12.5%) received broad-spectrum antibiotics. The overall prevalence of antibiotic use varied across hospitals from 22.3% to 51.9%. Antibiotic use prevalence was 29.2% among medical patients and 47.7% among surgical patients. Although there was no significant seasonal variation in antibiotic use prevalence, regional prevalence varied, ranging from 32.7% in the Midwest to 40.2% in the West (P < .001). Among units, pediatric intensive care unit patients had the highest prevalence of both overall and broad-spectrum antibiotic use at 58.3% and 26.6%, respectively (P < .001).

Conclusions:

On any given day in a national network of children’s hospitals, more than one-third of hospitalized children received an antibiotic, and 1 in 8 received a broad-spectrum antibiotic. Variation across hospitals, setting and regions identifies potential opportunities for enhanced antibiotic stewardship activities.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 5 , May 2020 , pp. 571 - 578
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved

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Footnotes

a

Authors of equal contribution.

PREVIOUS PRESENTATION: An abstract for this research was presented as a poster at IDWeek 2019 on October 4, 2019, in Washington, DC.

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