| Summary: | 碩士 === 國立成功大學 === 臨床藥學與藥物科技研究所 === 105 === The antimicrobials are most common prescribed in children, but due to the lack of research in pediatric population, we know little about the resistance pattern and utilization of antimicrobials in this population. The existed literature about infections and pathogens in pediatric population often focus on specific situations or patients with specific diseases, such as oncological or community-acquired diseases. This study was aimed to estimate pediatric antimicrobial resistance, bloodstream infection rates and pathogens, and to describe the antimicrobial prescribing pattern by monthly point prevalence survey (PPS). We documented the positive blood cultures during August 2016 to May 2017 and the inclusion criteria were isolates reported studied pathogens, hospitalized patients aged less than 18 years old. Monthly PPS were conducted in 2016, selecting the survey days by simple random sampling. The participating wards were neonatal ICU (NICU), pediatric ICU (PICU) and general pediatric medical ward (GPMW). There were 49 isolates from 45 pediatric patients enrolled. Thirty-one (63%) of these 49 isolates were resistant pathogens. The resistance of E. coli to first-line empirical medications, like ampicillin/sulbactam and gentamicin, was serious than early study and general population. In the study of prescribing pattern, there were 573 person-times met the enrolled criteria, and 371 (65%) of them had been prescribed at least one antimicrobial. A total of 645 antimicrobial prescriptions were documented, in which the combinations of penicillins including beta-lactamase inhibitor were the most prescribed medications. Of all prescriptions, 79.1% were for therapeutic and 20.9% were for prophylactic use. The most common therapeutic indication was lower respiratory tract infections. In this pilot study, we establish a model that can be applied to multicenter studies in the future. Moreover, this study emphasized the need of antimicrobial resistance and utilization monitoring system for pediatric population.
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