Antibiotic Surveillance in the Pediatric Intensive Care Unit (PICU) at Sanglah Hospital Denpasar in the Year of 2015-2017

Abstract

Background: Antibiotic surveillance in hospital settings is mandatory for optimal antibiotic therapy for the patient. Only a small number of studies have focused on antibiotic surveillance in hospitalized newborns, infants, and children. Objectives: The goal was to evaluate antibiotic use in our Pediatric Intensive Care Unit (PICU) and evaluate it for a possible association with the length of PICU stay. Methods: A retrospective, observational, cohort study was conducted from January 2015 to April 2017, involving subjects who were hospitalized in the PICU at Sanglah Hospital. The inclusion criteria were children aged between 1-month-12-years old, who had a blood culture and antibiotic sensitivity test result in their medical record. The exclusion criteria were incomplete medical records, blood cultures showing 2 types of bacteria at the same time (gram-positive and negative), or contaminated blood results. Factors associated with mortality were analyzed using a Chi-square test, with p < 0.05 considered to be statistically significant and the Risk Ratio (RR) of the associated factors was determined by 95% CI. Results: Multivariate analysis showed that the significant predictors of PICU length of stay were the appropriate continuation of antibiotics (RR 1.19; 95% CI 1.043 to 1.373; P = 0.047). There were also significant results for antibiotic compatibility and length of stay (RR 3.6; 95% CI 0.869 to 15.428; P = 0.049). Conclusion: Appropriate continuation of antibiotics and the compatibility of continuation antibiotics were significant predictors of length of PICU stay based on multivariate analysis.