JMIR Publications

ABSTRACT

Background:

Because infections are a major driver of morbidity and mortality in children with hematologic or oncologic diseases, prescribing of antimicrobials often is high. However, excess and/or inappropriate use of antimicrobials is directly linked to the emergence of antimicrobial resistance. Although point prevalence studies have examined the extent of antimicrobial use, comprehensive, qualitative evaluation of individual antimicrobial prescriptions remains lacking.

Objective:

The study’s aim is to identify appropriate versus inappropriate antimicrobial use among paediatric cancer patients and to subsequently report these findings to participating centres. In addition, this study also hopes to improve quality of patient care by informing centres about discrepancies between internal standards of care and national guidelines.

Methods:

Our point prevalence study is conducted by paediatric cancer centres in Germany and Austria. All patients under 18-years-old who are hospitalised at the time of the study are included. As a supplement to the point prevalence study, an expert panel is qualitatively assessing each of the antimicrobial prescriptions at the participating centres in order to review local guidelines and compare them with national guidelines.

Results:

As of December 2021, the point prevalence survey has been conducted at 30 sites, and expert panel adjudication for qualitative assessment of each antimicrobial use is ongoing. Results of the study are expected for 2022.

Conclusions:

This is the first point prevalence study conducted among paediatric cancer centres with an integrated, multi-step, qualitative approach that assesses each antimicrobial prescription. The results of this study will inform possible interventions for internal guidelines and antimicrobial stewardship programs implemented at paediatric cancer centres. In addition, local guidelines will be compared with national guidelines. Furthermore, this study will contribute to the overall integration of antimicrobial stewardship principles and initiatives in paediatric oncology and haematology, thereby improving safety and quality-of-care for children and adolescents with cancer and blood disorders.