Development of Antimicrobial Defined Daily Dose (DDD) for the Pediatric Population

Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improve patient outcomes, and reduce resistance. To assess the effectiveness of ASPs, it is necessary to have indicators that can be widely used. Defined daily dose (DDD) was designed by WHO for the adult population as a consumpti...

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Bibliographic Details
Published in:Antibiotics (Basel) 2023-01, Vol.12 (2), p.276
Main Authors: Montecatine-Alonso, Elena, Mejías-Trueba, Marta, Goycochea-Valdivia, Walter Alfredo, Chavarri-Gil, Estibaliz, Fernández-Llamazares, Cecilia M, Dolz, Elisenda, Gutiérrez-Urbón, José María, Gallego-Fernández, Carmen, Llorente-Gutiérrez, Jesús, Gil-Navarro, María Victoria
Format: Article
Language:English
Subjects:
Age
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial stewardship program
antimicrobials
Computerized physician order entry
Computers
Consumption
Consumption (Economics)
Data collection
defined daily dose (DDD)
Delphi method
Drug resistance
Hospitals
Indicators
Metronidazole
Normal distribution
Optimization
pediatric
Pediatrics
Penicillin G
Population
Prescriptions
Services
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Summary:Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improve patient outcomes, and reduce resistance. To assess the effectiveness of ASPs, it is necessary to have indicators that can be widely used. Defined daily dose (DDD) was designed by WHO for the adult population as a consumption indicator. However, there are no DDDs adapted to the pediatric population. The main objective of this study is to establish the most appropriate DDD values in this population. An observational, retrospective, multicenter study was conducted. Antimicrobial prescriptions were collected from pediatric wards of seven Spanish tertiary hospitals for 2 years. The DDDs obtained from the prescriptions were compared with the theoretical DDDs agreed upon in the first stage. To select the optimal DDD, the following were analyzed: power value, magnitude obtained from the differences in the DDD, statistical significance, and degree of agreement in the stipulated doses. A total of 4788 prescriptions were collected. Pediatric DDD was defined for 30 different antimicrobials. A potency >80% was obtained in 24 antibiotics. 51.2% of the selected DDD correspond to Phase I and 39.5% from Phase II. Pediatric DDD of different antimicrobials was obtained, providing an indicator that can be used globally in different hospitals to analyze the consumption and efficacy of ASPs.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12020276