The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Achievable rates and outage probability of cognitive radio with dynamic frequency hopping under imperfect spectrum sensing

In this study, the authors propose simple methods to evaluate the achievable rates and outage probability of a cognitive radio (CR) link that takes into account the imperfectness of spectrum sensing. In the considered system, the CR transmitter and receiver correlatively sense and dynamically exploit the spectrum pool via dynamic frequency hopping. Under imperfect spectrum sensing, false-alarm and miss-detection occur which cause impulsive interference emerged from collisions due to the simultaneous spectrum access of primary and cognitive users. That makes it very challenging to evaluate the achievable rates. By first examining the static link where the channel is assumed to be constant over time, they show that the achievable rate using a Gaussian input can be calculated accurately through a simple series representation. In the second part of this study, they extend the calculation of the achievable rate to wireless fading environments. To take into account the effect of fading, they introduce a piece-wise linear curve fitting-based method to approximate the instantaneous achievable rate curve as a combination of linear segments. It is then demonstrated that the ergodic achievable rate in fast fading and the outage probability in slow fading can be calculated to achieve any given accuracy level.