Custos de antimicrobianos associados às infecções bacterianas em crianças e adolescente hospitalizados

Background and Objective: Healthcare-Associated Infections (HAIs) in hospitalized children and adolescents represent a significant challenge due to increasing bacterial resistance and the high costs associated with antimicrobial use. Understanding these factors is essential to optimizing antimicrobial use and reducing clinical and economic impacts. This study aims to describe the costs of antimicrobials associated with bacterial infections in hospitalized children and adolescents. Methods: This is an analytical cross-sectional study conducted in two philanthropic hospitals in northern Paraná, Brazil. A total of 234 children and adolescents with HAIs and positive cultures were included between January 2018 and December 2023. Demographic, clinical, and antimicrobial cost data were collected from electronic medical records. For statistical analysis, the Mann-Whitney U test and Spearman’s correlation coefficient were used. Multiple linear regression was performed using the enter method. Results: Infections caused by resistant microorganisms occurred in 39.3% of cases. Age, length of hospital stay, and antimicrobial susceptibility profile were associated with higher antimicrobial costs. Patients with resistant microorganisms had antimicrobial costs approximately five times higher than those with susceptible microorganisms. Gram-negative bacteria were predominated, with Klebsiella pneumoniae and Pseudomonas aeruginosa being multidrug-resistant species. The most frequently prescribed antimicrobials were aminoglycosides, followed by penicillins combined with beta-lactamase inhibitors, and cephalosporins. Conclusion: Age, length of hospital stay, and microbial resistance were significant predictors of antimicrobial costs in hospitalized children and adolescents. Infection control strategies and the rational use of antimicrobials are essential to reducing hospital costs and mitigating bacterial resistance.