Evaluation of Meropenem Usage Patterns in the Paediatric and Cardiac Critical Care Units at the Hospital for Sick Children
CCCF ePoster library. Karnieg T. Oct 26, 2015; 114775; P30
Ms. Taleen Karnieg
Ms. Taleen Karnieg
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Abstract
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P30


Topic: Quality Assurance/Quality Improvement Project


Evaluation of Meropenem Usage Patterns in the Paediatric and Cardiac Critical Care Units at the Hospital for Sick Children



Taleen Karnieg, S. Pong, M. Clarke, M. Science, S. Schwartz, P. Cox, W. Seto

Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada | Pharmacy, The Hospital for Sick Children, Toronto, Canada | Infection Prevention & Control, The Hospital for Sick Children, Toronto, Canada | Infectious Diseases, The Hospital for Sick Children, Toronto, Canada | Critical Care Medicine, The Hospital for Sick Children, Toronto, Canada | Critical Care Medicine, The Hospital for Sick Children, Toronto, Canada | Pharmacy, The Hospital for Sick Children, Toronto, Canada

Introduction: A recent point prevalence survey in the paediatric intensive care unit (PICU) and cardiac critical care unit (CCCU) at the Hospital for Sick Children (SickKids) identified inappropriate antimicrobial usage ranging from 15.4 to 52.5% of courses1. The most common reason for inappropriate use was “overly broad-spectrum” antimicrobials1. The use of overly broad-spectrum antimicrobials, such as meropenem, has been linked to increased rates of resistant organisms. Meropenem is a broad-spectrum antimicrobial which provides coverage for both gram positive and gram negative bacterial organisms with beta-lactamase resistant properties. At SickKids, meropenem use is restricted to patients who have received a consultation by the Infectious Diseases (ID) team3,4. The susceptibility of meropenem at SickKids remained close to 100% for most isolates; however, there are increased concerns for resistance rates of meropenem and other broad spectrum antimicrobials5.

Objectives:

To conduct a retrospective drug use evaluation of meropenem to describe its use in patients admitted to the PICU & CCCU at SickKids in order to gain an understanding of the current prescribing practices of meropenem.



Methods:

A retrospective chart review will be conducted to look at the PICU & CCCU patients over 12 months (January 2014-December 2014) who received meropenem for at least 72 hours. Eligible patients were extracted from the Client Information Management System (CIMS). Information about the patients’ PICU & CCCU stay (e.g., previous antimicrobial use, indication for antimicrobial prescribing, diagnosis, source of infection, duration of therapy) will be gathered from CIMS, microbiology data will be extracted from KidCare (the main clinical information system used throughout SickKids), and transfer and admission notes will be accessed through CIMS or Electronic Patient Chart (EPC), as appropriate. Study data will be collected using Research Electronic Data Capture (REDCap) and descriptive summary statistics will be reported by using Microsoft® Excel and Statistical Analysis System (SAS) software, as appropriate.



Results: Final study results pending by September 2015

Conclusion: NA

References:

1. De Castro, C, Pong, S, Lau, E, Boodhan, S, Timberlake, K, Bitnun, SA, Richardson, S, Clarke, M, Zhao, X, Cox, P, Schwartz, SM, Seto, W. 2015. Follow-up prevalence survey of antimicrobial utilization in the cardiac and paediatric critical care unit. Manuscript submitted for publication.

2. Patterson JE. 2001. Antibiotic utilization: is there an effect on antimicrobial resistance? Chest. 119(2 Suppl):426S-30S

3. Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, HootonTM; Infectious Diseases Societyof America; Society for Healthcare Epidemiology of America. 2007. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 44(2):159-77.

4. Chen, J, Lau, E. 2013. Meropenem. In: Drug Handbook And Formulary, 2013-2014. Toronto: Hospital for Sick Children. Page 181.

5. Pong, S. Antibiogram Data: PICU & CCCU 2012-2013. 2014. SickKids internal data

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