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41 results

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  • Prospective monitoring of carbapenem use and pseudomonal resistance across pediatric institutions

  • Isao Miyairi, Kensuke Shoji, Noriko Kinoshita, Junpei Saitoh, Yoshie Sugahara, Yasushi Watanabe, Makoto Komura, Masashi Kasai, Yuho Horikoshi, Masayoshi Shinjoh, Takashi Igarashi
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 41 / Issue 9 / September 2020
    Published online by Cambridge University Press:
    02 June 2020, pp. 1042-1047
    Print publication:
    September 2020
  • Objective:

    To determine whether carbapenem consumption and Pseudomonas aeruginosa resistance rates can be used as benchmarks to compare and improve antimicrobial stewardship programs across multiple pediatric hospitals.

    Design:

    A prospective study.

    Setting and participants:

    Healthcare institutions in Japan with >100 pediatric beds.

    Methods:

    An annual survey of the total days of therapy (DOT) per 1,000 patient days for carbapenem antibiotics (meropenem, imipenem-cilastatin, panipenem-betamipron, doripenem) and susceptibility rates of Pseudomonas aeruginosa to meropenem and imipenem-cilastatin from each institution was conducted over a 7-year period. Data were reported to the administration, as well as to the infection control team, of each institution annually.

    Results:

    Data were obtained from 32 facilities. The median total carbapenem DOT per 1,000 patient days was 16.6 and varied widely, with a range of 2.7 to 59.0. The median susceptibility to meropenem was 86.6%, ranging from 78.6% to 96.6%. We detected an inverse correlation between total carbapenem DOT versus susceptibility (r = – 0.36; P < .01). Over the 7-year period, the DOT per 1,000 patient days of carbapenem decreased by 27% from a median of 16.0 to 11.7 (P < .01). We also observed an improvement in susceptibility to meropenem from a median of 87% to 89.7% (P = .01) and to imipenem-cilastatin from 79% to 85% (P < .01). The decreases in the use of carbapenem were greater in institutions with antimicrobial stewardship programs led by pediatric infectious disease specialists.

    Conclusions:

    Antimicrobial use and resistance, targeting carbapenems and P. aeruginosa, respectively, can serve as benchmarks that can be utilized to promote antimicrobial stewardship across pediatric healthcare institutions.

  • 1 - Bayesian Learning

  • from Part I - Formulation
  • Shinichi Nakajima, Technische Universität Berlin, Kazuho Watanabe, Masashi Sugiyama, University of Tokyo
  • Book:
    Variational Bayesian Learning Theory
    Published online:
    24 June 2019
    Print publication:
    11 July 2019, pp 3-38
    • Chapter
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