P40 Comparison of antibiotic consumption between pediatric hospitals

Background Antibiotic exposure and reduced microbiome diversity in early childhood are associated with the incidence of inflammatory bowel disease, 1 asthma 2 and type-1 diabetes 3 later in life. Together with the emergence of microbial resistance, those adverse effects of antibiotics impacting on the individual and population levels. Periodic monitoring of therapeutically used antibiotics in the framework of antimicrobial stewardship is required for their effective and restricted use in hospitals. Children´s hospitals face two challenges for a meaningful quantification of antibiotic consumption: § Firstly, the algorithm DDD/inpatient days used in adult patients do not take into account the heterogeneity of the pediatric population. Up to date there is no global consensus on how to calculate and interpret the antibiotic consumption of wards and hospitals for children. § Second challenge is the relative scarcity of suitable pediatric hospitals as basis for comparison. This study deals with the comparison and interpretation of antibiotic consumption between two similarly structured children´s hospitals in Austria. Methodology The annual use of antibiotics was assessed in two large pediatric clinical settings at geographically distinct locations in Austria, encompassing all relevant wards, such as neonatology, internal medicine, surgery, pediatric oncology and PICU´s. The analysis discriminates among the wards and classes of antibiotics. In addition to DDD and inpatient days, alternative parameters such as number of patient-admittances and number of used vials were included in the calculation. Result Pediatric-specific pitfalls affecting the quantification and comparability were identified: Hospital guidelines concerning the multiple usage of dissolved and diluted antibiotics. Regional composition of the pediatric patient population in terms of pathology. Intramural allocations of wards sharing the drug deposit. Conclusion Unexpected factors have severe impact on the reliability of annual antibiotic quantification and interpretation. Those factors need to be taken into account when comparing pediatric hospitals. References Am J Gastroenterol 2010 Dec;105(12):2687–92. Nat Commun 2018 Jan;9(1):141. Cell 2016 May;165(4):842–53. Disclosure(s) Nothing to disclose