Algorithm for auditing the rationality of clinical practice of using antibiotics in hospitals for children

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Аннотация

Background. The problem of irrational use of antibiotics in children’s hospitals remains relevant. To effectively solve this problem, it is obvious that there is a need to create standards for auditing clinical practice and a unified strategy for monitoring the use of antibiotics both in individual institutions and at the level of regional health authorities. A review of modern pharmaco-epidemiological methods aimed at determining the main criteria of the audit algorithm as a key tool in developing a strategy for monitoring the clinical practice of using antimicrobial drugs was conducted.

Objective. Creation of the audit algorithm for assessing the rationality of the clinical practice of using antibiotics for children’s hospitals.

Methods. A comprehensive assessment of the rationality of antibiotic use in children’s hospitals included an analysis of antibiotic consumption using the WHOAWaRe method based on ATC/DDD analysis for the previous year, as well as an assessment of the clinical practice of using antibiotics based on primary medical documentation by a checklist from the «Toolkit for assessing the quality of inpatient care for children» of the World Health Organization.

Results. The analysis of antibiotic consumption in a specific pediatric hospital, conducted using the WHOAWaRe method and ATC/DDD analysis for the previous year, showed signs of potentially irrational clinical practice in cases where antibiotics from the «Access» category in oral forms are not used, as well as if the share of antibiotics from the «Control» category exceeds the consumption of antibiotics from the «Access» category, or the share of antibiotics from the «Reserve» category is 10% or more. The results of assessing antibiotic consumption in pediatric hospitals using the WHOAWaRe method were fully consistent with the results of the analysis of primary medical documentation using the checklist of the World Health Organization tools.

Conclusion. When implementing a strategy for monitoring antimicrobial consumption in a pediatric hospital at the stage of clinical practice audit, it is advisable to integrate consumption data collected using the WHOAWaRe methodology with the results of a structured analysis of primary medical documentation. This will not only identify trends in the use of antibiotics, but also clarify the factors that contribute to or hinder the maintenance of rational clinical practice.

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Авторлар туралы

A. Vlasova

Department for the implementation of Functions, National Medical Research Center for Pediatrics, Pirogov Russian National Research Medical University; Morozov Children’s City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Хат алмасуға жауапты Автор.
Email: annavlasova75@mail.ru
ORCID iD: 0000-0001-5272-2070
SPIN-код: 5248-6411

Cand. Sci. (Med.), Head of the Department of Clinical Pharmacology, Morozov Children’s City Clinical Hospital, Moscow Healthcare Department; Expert Analyst, Department of Implementation of Functions, National Medical Research Center for Pediatrics, Pirogov Russian National Research Medical University; Associate Professor, Department of Clinical Pharmacology and Therapy n.a. Academician B.E. Votchal, Russian Medical Academy of Continuous Professional Education

Ресей, Moscow; Moscow; Moscow

Әдебиет тізімі

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1. JATS XML
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2. Fig. 1. WHOAWaRe capabilities after adaptation to clinical guidelines for assessing antibiotic consumption using the example of children's hospitals in 9 constituent entities of the Russian Federation

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3. Fig. 2. Result of the analysis of clinical practice for 3139 inpatient cards based on the WHO checklist

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