Use of the World Health Organization Access, Watch, and Reserve Classification to Follow Trends in Prescription of Antibiotic Use in Two Pediatric Intensive Care Units in Rio de Janeiro, Brazil

2020 ◽  
Vol 15 (03) ◽  
pp. 155-160
Author(s):  
André Ricardo Araujo da Silva ◽  
Cristina Vieira de Souza Oliveira ◽  
Cristiane Henriques Teixeira ◽  
Izabel Alves Leal
Keyword(s):  
Time Series ◽  
Intensive Care ◽  
Time Series Analysis ◽  
World Health Organization ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
World Health ◽  
The World ◽  
Health Organization

Abstract Objective The recommended percentage of antibiotic use in pediatric intensive care units (PICUs) using the World Health Organization (WHO) Access, Watch, and Reserve (AWaRE) classification is not known. Methods We have conducted an interrupted time series analysis in two PICUs in Rio de Janeiro, Brazil, over a period of 18 months. The type of antibiotics used was evaluated using the WHO AWaRE classification, and the amount of antibiotic was measured using days of therapy/1,000 patient-days (DOT/1000PD) after implementation of an antimicrobial stewardship program (ASP). The first and last semesters were compared using medians and the Mann–Whitney's test. The trends of antibiotic consumption were performed using time series analysis in three consecutive 6-month periods. Results A total of 2,205 patients were admitted, accounting for 12,490 patient-days. In PICU 1, overall antibiotic consumption (in DOT/1000PD) was 1,322 in the first 6 months of analysis and 1,264.5 in the last 6 months (p = 0.81). In PICU 2, the consumption for the same period was 1,638.5 and 1,344.5, respectively (p = 0.031). In PICU 1, the antibiotics classified in the AWaRE groups were used 33.2, 57.9, and 8.4% of the time, respectively. The remaining 0.5% of antibiotics used were not classified in any of these groups. In PICU 2, the AWaRE groups corresponded to 30.2, 60.5, and 9.3% of all antibiotics used, respectively. There was no use of unclassified antibiotics in this unit. The use of all three groups of WHO AWaRE antibiotics was similar in the first and the last semesters, with the exception of Reserve group in PICU 2 (183.5 × 92, p = 0.031). Conclusion A significant reduction of overall antibiotic use and also in the Reserve group was achieved in one of the PICU units studied. The antibiotics classified in the Watch group were the most used in both units, representing ∼60% of all the antibiotics consumed.

scholarly journals Evaluation of Antibiotic Use in Kazakhstan for the Period 2017–2019 Based on WHO Access, Watch and Reserve Classification (AWaRe 2019)

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 58
Author(s):  
Gulzira Zhussupova ◽  
Dinara Utepova ◽  
Galiya Orazova ◽  
Saule Zhaldybayeva ◽  
Galina Skvirskaya ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
World Health Organization ◽  
Antibiotic Use ◽  
The State ◽  
World Health ◽  
Defined Daily Dose ◽  
Upward Trend ◽  
The World ◽  
Daily Dose ◽  
Health Organization

The purpose of this study is to conduct a comparative analysis of the consumption of antibiotics for systemic use reimbursed by the state in Kazakhstan for 2017–2019 with the Access, Watch, and Reserve classification (AWaRe 2019) of the World Health Organization (WHO). The evaluation of the consumption of antibiotics for systemic use in Kazakhstan for 2017–2019 was carried out using the ATC/DDD methodology in accordance with the WHO AWaRe classification. The study used data on all antibiotics that were centrally purchased by a single purchaser during the study period. To understand how often Access group antibiotics are taken in Kazakhstan, the top-10 most consumed antibiotics were additionally studied. The results of a comparative analysis of the antibiotics for systemic use consumption for 2017–2019 by the Access, Watch, and Reserve groups showed a negative trend of a decrease in the consumption of Access group drugs from 1.17 defined daily dose (DDDs) per 1000 inhabitants per day (DID) (39%) in 2017 to 0.59 DID (30%) in 2019. There is an increase in consumption of Watch group antibiotics from 1.84 DID (61%) in 2017 to 1.37 DID (68%) in 2019, as well as an increase in consumption of Reserve antibiotics from 0.001 DID (0.03%) to 0.4 DID (2.11%). In recent years in Kazakhstan, there has been a decrease in the consumption of Access group antibiotics. In addition, the Watch group antibiotics are widely consumed with a certain upward trend. In 2019, one Reserve antibiotic was included in the top-10 most commonly consumed antibiotics. There is a predominant consumption of parenteral forms of antibiotics for systemic use in the country.

scholarly journals Antibiotic consumption monitoring at the Institute of Otorhinolaryngology and Maxillofacial Surgery - Clinical Center of Serbia in 2001-2003

2005 ◽  
Vol 62 (7-8) ◽  
pp. 551-555 ◽  
Author(s):  
Dragana Kastratovic ◽  
Vojko Djukic ◽  
Branislava Majstorovic ◽  
Jan Komrska ◽  
Milan Gajic ◽  
...  
Keyword(s):  
World Health Organization ◽  
Maxillofacial Surgery ◽  
Antibiotic Consumption ◽  
World Health ◽  
International Trends ◽  
Clinical Center ◽  
The World ◽  
Health Organization

Background. At the Clinical Center of Serbia (CCS), which includes 21 Institutes and 6 Centers, approximately 10% of the total annual budgetary funds is spent on the drugs. During the studied period, it was estimated that 0.5% of the above amount has been spent at the Institute for Otorhinolaryngology and Maxillofacial surgery (Institute for ORL and MFS), Clinical Center of Serbia. The aim of this study was to find out if these antibiotics had been used rationally by the monitoring of antibiotics in relation to the number of inpatients, and by the 5 most frequent diagnoses. Methods. The authors monitored the tree-year consumption of antibiotics for In hospital treated patients during the period 2001-2003. Data were obtained from the itemized quarterly report on the consumption by the Central Pharmacy of the CCS. Results. The results were statistically analyzed and presented in percentages and Defined Daily Dasages (DDD) for each group of the antibiotics. The results were analyzed in accordance with the World Health Organization Recommendations and the Guidelines. Conclusion. The authors concluded that antibiotics were adequately used at the Institute for ORL and MFS-CCS. The most commonly used antibiotics for grampositive infections were those from the penicillin and cephalosporin groups. According to the international trends and recommendations, the selected therapy was rational and the antibiotics consumption was cut down during the observed three-year period. It was a true confirmation that the recommendations for the rational antibiotics consumption had been fruitful (produced good results).

scholarly journals Role of a Neonatal Intensive Care Unit during the COVID-19 Pandemia: recommendations from the neonatology discipline

2020 ◽  
Vol 66 (7) ◽  
pp. 894-897
Author(s):  
Werther Brunow de Carvalho ◽  
Maria Augusta Bento Cicaroni Gibelli ◽  
Vera Lucia Jornada Krebs ◽  
Carla Regina Tragante ◽  
Maria Beatriz Moliterno Perondi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
World Health Organization ◽  
Neonatal Intensive Care ◽  
World Health ◽  
The Third ◽  
The World ◽  
Health Organization

SUMMARY On 11th March 2020, the World Health Organization (WHO) declared the COVID-19 a pandemic. The Obstetrics and Neonatology disciplines needed to be revised to suit the institutional need to expand intensive care beds to care for confirmed or suspected patients with COVID-19 in the state of São Paulo, following the recommendations of the Institutional Crisis Committee. Three different actions were needed: the structuring of teams and advanced medical post to attend COVID-19-free patients and those with suspect or confirmed COVID-19; elaborating the protocols from the delivery room throughout hospitalization. Some special considerations about breastfeeding and rooming-in were needed. The third action was the drafting of a protocol to admit infants from other hospitals with confirmed COVID-19 as the unit never admitted outpatients before.

scholarly journals The Impact of Weather on Hospitalization due to Pneumonia Among Children in Nghe An from 2014 to 2019

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Nguyen Chi Sy ◽  
Le Tu Hoang ◽  
Nguyen Thi Trang Nhung ◽  
Vu Thi Hoang Lan ◽  
Tran Minh Dien
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
World Health Organization ◽  
Risk Index ◽  
Daily Temperature ◽  
World Health ◽  
Series Analysis ◽  
Study Results ◽  
Health Organization ◽  
The Impact

This paper studies the impact of weather on the number of under 15-year-old children hospitalized for pneumonia at Nghe An Pediatric Hospital using time series analysis of the data collected from 2014 to 2019. The study was carried out on 45,466 children, most of whom were under 5 years old. The study results show that there was a statistically significant inverse correlation between mean daily temperature and children’s hospitalization for pneumonia while humidity was positively correlated. Specifically, when the average daily temperature increased by 1 degree Celsius, the risk of hospitalization for pneumonia on the same day decreased by 1% (95% CI: 0.3 - 1.7%); whereas when the humidity increased, the risk of hospitalization increased by 14.4% (95% CI: 0.2 - 30.7%) on the day of hospitalization; risk increased by 16.5% (95% CI: 9.5 - 23.9%) one day before hospitalization; and risk increased by 15.2% (95% CI: 8.2 - 22.7%) two days before hospitalization. The results suggest that children are highly sensitive to weather factors, including temperature and humidity; therefore, it is necessary to take measures to protect children against changing weather. Keywords Weather, pneumonia, children, effect. References [1] I. Rudan, et al., Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health Organization 86(5) (2008) 408-416.[2] M. Harris, et al., British Thoracic Society guidelines for the management of community acquired pneumonia in children: update Thorax, 66 (2011) (Suppl 2): p. ii1.[3] Margolis, P. and A. Gadomski, The rational clinical examination. Does this infant have pneumonia? Jama 279(4) (1998) 308-13.[4] World Health Organization, Handbook : IMCI integrated management of childhood illness. 2005, World Health Organization: Geneva.[5] Sönke Kreft, David Eckstein, and Inga Melchior, Global Climate Risk Index 2017, Germanwatch Nord-Süd Initiative e.V.,.[6] Pham Khoi Nguyen, Vietnam's event about sea level rising and climate chang, 2009, Ministry of Natural resources and enviroment.[7] L.M.T. Luong, et al., Effects of temperature on hospitalisation among pre-school children in Hanoi, Vietnam, 26(3) (2019) 2603-2612.[8] D. Phung, et al., Temperature as a risk factor for hospitalisations among young children in the Mekong Delta area, Vietnam. Occupational and Environmental Medicine 72(7) (2015) 529.[9] J. Gao, et al., Impact of ambient humidity on child health: a systematic review. PloS one 9(12) (2014) p. e112508-e112508.[10] Y. Liu, et al., Temporal relationship between hospital admissions for pneumonia and weather conditions in Shanghai, China: a time-series analysis. BMJ Open, 4(7) (2014) p. e004961.[11] T. Egondi, et al., Time-series analysis of weather and mortality patterns in Nairobi's informal settlements. Global health action, 5 (2012) 23-32.[12] Leckebusch, G.C. and A.F. Abdussalam, Climate and socioeconomic influences on interannual variability of cholera in Nigeria. Health Place, 34 (2015) 107-17.        

scholarly journals Effects of government policies and the Nowruz holidays on confirmed COVID-19 cases in Iran: An intervention time series analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256516
Author(s):  
Ali Hadianfar ◽  
Razieh Yousefi ◽  
Milad Delavary ◽  
Vahid Fakoor ◽  
Mohammad Taghi Shakeri ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Government Policies ◽  
World Health ◽  
Social Distancing ◽  
Social Interventions ◽  
Series Analysis ◽  
Daily Data ◽  
The World ◽  
Health Organization

Background Public health policies with varying degrees of restriction have been imposed around the world to prevent the spread of coronavirus disease 2019 (COVID-19). In this study, we aimed to evaluate the effects of the implementation of government policies and the Nowruz holidays on the containment of the COVID-19 pandemic in Iran, using an intervention time series analysis. Methods Daily data on COVID-19 cases registered between February 19 and May 2, 2020 were collected from the World Health Organization (WHO)’s website. Using an intervention time series modeling, the effect of two government policies on the number of confirmed cases were evaluated, namely the closing of schools and universities, and the implementation of social distancing measures. Furthermore, the effect of the Nowruz holidays as a non-intervention factor for the spread of COVID-19 was also analyzed. Results The results showed that, after the implementation of the first intervention, i.e., the closing of universities and schools, no statistically significant change was found in the number of new confirmed cases. The Nowruz holidays was followed by a significant increase in new cases (1,872.20; 95% CI, 1,257.60 to 2,476.79; p<0.001)), while the implementation of social distancing measures was followed by a significant decrease in such cases (2,182.80; 95% CI, 1,556.56 to 2,809.04; p<0.001). Conclusion The Nowruz holidays and the implementation of social distancing measures in Iran were related to a significant increase and decrease in COVID-19 cases, respectively. These results highlight the necessity of measuring the effect of health and social interventions for their future implementations.

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