High Rates of Prescribing Antimicrobials for Prophylaxis in Children and
Neonates: Results From the Antibiotic Resistance and Prescribing in
European Children Point Prevalence Survey
Background. This study was conducted to assess the variation in
prescription practices for systemic antimicrobial agents used for
prophylaxis among pediatric patients hospitalized in 41 countries
worldwide.
Methods. Using the standardized Antibiotic Resistance and Prescribing in
European Children Point Prevalence Survey protocol, a cross-sectional
point-prevalence survey was conducted at 226 pediatric hospitals in 41
countries from October 1 to November 30, 2012.
Results. Overall, 17 693 pediatric patients were surveyed and 36.7% of
them received antibiotics (n = 6499). Of 6818 inpatient children, 2242
(32.9%) received at least 1 antimicrobial for prophylactic use. Of 11
899 prescriptions for antimicrobials, 3400 (28.6%) were provided for
prophylactic use. Prophylaxis for medical diseases was the indication in
73.4% of cases (2495 of 3400), whereas 26.6% of prescriptions were for
surgical diseases (905 of 3400). In approximately half the cases (48.7%
[1656 of 3400]), a combination of 2 or more antimicrobials was
prescribed. The use of broad-spectrum antibiotics (BSAs), which included
tetracyclines, macrolides, lincosamides, and sulfonamides/trimethoprim,
was high (51.8% [1761 of 3400]). Broad-spectrum antibiotic use for
medical prophylaxis was more common in Asia (risk ratio [RR], 1.322;
95% confidence interval [CI], 1.202-1.653) and more restricted in
Australia (RR, 0.619; 95% CI, 0.521-0.736). Prescription of BSA for
surgical prophylaxis also varied according to United Nations region.
Finally, a high percentage of surgical patients (79.7% [721 of 905])
received their prophylaxis for longer than 1 day.
Conclusions. A high proportion of hospitalized children received
prophylactic BSAs. This represents a clear target for quality
improvement. Collectively speaking, it is critical to reduce total
prophylactic prescribing, BSA use, and prolonged prescription
