Antimicrobial usage among hospitalized children in Latvia : A neonatal and pediatric antimicrobial point prevalence survey

Publisher Copyright: © 2014 Lithuanian University of Health Sciences.Background and objective: The point prevalence survey was conducted as part of the Antibiotic Resistance and Prescribing in European Children (ARPEC) Project. The study aimed at analyzing pediatric and neonatal antimicrobial prescribing patterns in Latvian hospitals, to identify targets for quality improvement. Materials and methods: A one day cross-sectional point prevalence survey on antibiotic use in hospitalized children was conducted in November 2012 in 10 Latvian hospitals, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Results: Overall 549 patients were included in the study; 167 (39%) patients admitted to pediatric wards and 25 (21%) patients admitted to neonatal wards received at least one antimicrobial. Pediatric top three antibiotic groups were third-generation cephalosporins (55 prescriptions, 28%), extended spectrum penicillins (n=. 32, 16%) and first-generation cephalosporins (n=. 26, 13%). Eleven pediatric patients (85%) received surgical prophylaxis more than 1 day; 143 pediatric patients (86%) received antibiotics intravenously. Lower respiratory tract infections were the most common indications for antibiotic use both in pediatric (n=. 60, 35.9%) and neonatal patients (n=. 9, 36%). The most used antibiotics for neonatal patients were benzylpenicillin (n=. 12, 32%), and gentamicin (n=. 9, 24%). Conclusions: We identified a few problematic areas, which need improvement: the high use of third-generation cephalosporins for pediatric patients, prolonged surgical prophylaxis, predominant use of parenteral antibiotics and an urgent need for local antibiotic guidelines.publishersversionPeer reviewe

Observational Study of Antibiotic Usage at the Children’s Clinical University Hospital in Riga, Latvia

Publisher Copyright: © 2018 by the authors. Licensee MDPI, Basel, Switzerland.Background and objectives: Many pediatric patients have been treated with antibiotics during their hospitalization. There is a need to improve antibiotic prescribing for pediatric patients because many of these prescriptions are inappropriate. Antibiotic consumption analysis was conducted at the Children’s Clinical University Hospital to identify targets for quality improvement. Materials and Methods: A one day cross-sectional point prevalence survey (PPS) was conducted in May and November 2011–2013 using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antibiotic treatment on the day of survey. Total consumption of systemic antibiotics belonging to the ATC J01 class (except amphenicols (J01B) and a combination of antibacterials (J01R)) was also analyzed by using a defined daily dose (DDD) approach and antibiotic drug utilization (90%DU) for the period 2006–2015. Results were compared with results in 2017 using the DDD and 90%DU methodology. Results: The most commonly used antibiotic group in all PPS, except in May and November 2011, was other β-lactam antibiotics (J01D): 42 (40%) prescriptions in May 2013 and 66 (42%) and November 2011. In 2006–2015 and also in 2017, the most commonly used antibiotic groups were penicillins (J01C) and other β-lactam antibiotics (J01D)—76% (90%DU) of the total antibiotic consumption registered in 2006, 73% in 2015 and 70% in 2017. Starting in 2008, amoxicillin was the most commonly used antibiotic at the hospital. The usage of ceftriaxone increased from 3% in 2006 to 13% in 2015, but decreased in 2017 (7%). Conclusions: Study results from 2006–2015 showed that there was a need to establish a stronger antibiotic prescribing policy in the hospital reducing the use of broad-spectrum antibiotics (especially 3rd generation cephalosporins) and increasing the use of narrower spectrum antibiotics. It was partly achieved in 2017 with some reduction in ceftriaxone use.publishersversionPeer reviewe

Analysis of body composition of 9- and 10-year-old children in Latvia

Background and Objective: According to the data of epidemiologic research, the prevalence of both excessive and insufficient body weight is increasing in a pediatric population leading to the growing burden of health problems due to these changes. The aim of the study was to understand the current situation of physical development of 9- and 10-year-old boys and girls in Latvia and to estimate the prevalence of underweight, normal weight, overweight, and obesity among young adolescents. Material and Methods: During 2007-2009, a random sample of healthy 9-year-old (n=184) and 10-year-old (n=320) children from all regions and different socioeconomic groups of Latvia was surveyed in a cross-sectional study. The anthropometric measurements of height, weight, 3 circumferences, and 5 skinfolds were performed. The percentage of body fat was calculated by the equation of Slaughter et al. Body mass index and fat mass index were calculated for each respondent. Children were divided into groups according to these indexes. At the age of 9 years, 69.5% of boys had a normal nutritional level either by BMI or FMI, and 54.5% and 72.2% of the girls of the same age had a normal nutritional level by BMI and by FMI, respectively. Obesity according to BMI in 9-year-old boys was found to be 4.7% and in girls 6.1%; according to FMI, 3.7% and 2.3%, respectively. A similar trend was also observed in the cohort of 10-year-old children. Conclusions: The results of the research showed that the problem of high prevalence of Latvian children with underweight is not smaller than the problem of children with obesity. Evaluation of physical development in children based only body mass index may lead to overdiagnosis of obesity.publishersversionPeer reviewe

Kliniskie, morfologiskie un biomehaniskie iedzimto anorektalo anomaliju petijumi

Separate summary in Latvian and English, 84 p.Available from Latvian Academic Library / LAL - Latvian Academic LibrarySIGLELVLatvi

Analysis of Body Composition of 9- and 10-Year-Old Children in Latvia

Background and Objective: According to the data of epidemiologic research, the prevalence of both excessive and insufficient body weight is increasing in a pediatric population leading to the growing burden of health problems due to these changes. The aim of the study was to understand the current situation of physical development of 9- and 10-year-old boys and girls in Latvia and to estimate the prevalence of underweight, normal weight, overweight, and obesity among young adolescents. Material and Methods: During 2007-2009, a random sample of healthy 9-year-old (n=184) and 10-year-old (n=320) children from all regions and different socioeconomic groups of Latvia was surveyed in a cross-sectional study. The anthropometric measurements of height, weight, 3 circumferences, and 5 skinfolds were performed. The percentage of body fat was calculated by the equation of Slaughter et al. Body mass index and fat mass index were calculated for each respondent. Children were divided into groups according to these indexes. At the age of 9 years, 69.5% of boys had a normal nutritional level either by BMI or FMI, and 54.5% and 72.2% of the girls of the same age had a normal nutritional level by BMI and by FMI, respectively. Obesity according to BMI in 9-year-old boys was found to be 4.7% and in girls 6.1%; according to FMI, 3.7% and 2.3%, respectively. A similar trend was also observed in the cohort of 10-year-old children. Conclusions: The results of the research showed that the problem of high prevalence of Latvian children with underweight is not smaller than the problem of children with obesity. Evaluation of physical development in children based only body mass index may lead to overdiagnosis of obesity.Peer reviewe