Monitoring of pediatric antibiotic consumption using electronic medical records in an Italian tertiary care hospital

Investigation of antibiotic use in the pediatric population is crucial, in particular in the hospital setting. Measures of antibiotic consumption, such as Duration-Of-Therapy (DOT) and Length-Of-Therapy (LOT) are recommended as indicators of use in pediatrics. This study is aimed to estimate DOT and LOT in hospitalized children using data from electronic medical records (EMRs). We included all patients hospitalized in a tertiary care children's hospital in Italy, from January to December 2022. Measures DOT and LOT were derived from data recorded in patient EMRs. DOT/1000 patient-days was estimated by patient characteristics, antibiotic molecule prescribed and type of inpatient ward. The time trend of antimicrobial consumption in hospitalized children was also estimated. At least one antibiotic was prescribed in 8,518 out of 21,787 children (39.1%). Overall, DOT and LOT/1000 patient-days were 539 and 354, with a DOT/LOT ratio of 1.5. The molecule with the highest DOT/1000 patient-days was piperacillin/tazobactam followed by meropenem (81.3 and 59.6 DOT/1000 patient-days). Oncohematology and Intensive Care Units were the type of wards with highest DOT/1000 patient-days (1112 and 944, respectively) and LOT/1000 patient-days (591 and 547, respectively). EMRs enhances data accessibility to measure antibiotic use in hospitalized children and their integration into pediatric antibiotic stewardship programs.