Point Prevalence Survey on Antimicrobial Use in Pediatric Post-acute Care Facilities

Abstract

BackgroundAntimicrobial use data in adult nursing homes have been used to direct antimicrobial stewardship (AS) efforts for this healthcare setting. However, little is known about antimicrobial use in pediatric post-acute care facilities (pPACFs). The purpose of this study was to describe antimicrobial use in pPACFs.MethodsWe performed a point prevalence study of antimicrobial use in six geographically diverse pPACFs on two study dates: January 20 and July 20, 2016. Eligible facilities cared for residents 21 years old. Collected data were extracted from residentsÕ medical records and included antimicrobial agents given on the 2 study days; the indication for use, categorized as treatment of an infection, non-infectious use, e.g., dysmotility, or prophylaxis; and route of administration. Chi-squared tests were performed as applicable; P values < 0.05 were considered statistically significant.ResultsOn January 20, 10% (67/666) of residents received 82 antimicrobial agents of which 45% were given to treat an infection (Figure 1). On July 20, 7% (49/677) of residents received 58 antimicrobial agents of which 51% were given to treat an infection. Skin and soft-tissue infections (SSTIs) were the most common infectious indication, accounting for 24% and 27% of residents given an antimicrobial for infection in January and July, respectively (Figure 2). Respiratory tract infections (RTI) accounted for 3% of residents given an antimicrobial for infection in January compared with 16% in July (P < 0.01). For treatment of infections, there was no significant difference between the use of systemic (oral and intravenous) agents in January (63%) compared with July (48%, P = 0.2, Figure 3); cephalosporins (32%) were the most common agents used. In July, topical antimicrobials were more common (52%) of which mupirocin and clindamycin were most common.ConclusionIn pPACFs, antimicrobial agents were less commonly given for infections than for non-infectious indications and prophylaxis. SSTIs were the most common infection and topical agents were more commonly used to treat infections in July. Surprisingly, treatment of RTIs was more common in July. This study suggests that care guidelines could be useful in promoting AS efforts for pPACFs.Disclosures All authors: No reported disclosures.