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.

Neoliberal Capitalism, Social Reproduction Crisis, Gender Implications and Forms of Resistance: The case of Greece

Neoliberal capitalism and its accompanied austerity measures has had a profound effect on social reproduction throughout Europe. Social reproduction, ie, the process that makes it possible for individuals, families, and society to reproduce itself – is in crisis. The concept of social reproduction utilized in this presentation is framed within the feminist and Marxist tradition. Historically, social reproduction was met through both waged and unwaged work with women playing a predominant role either as waged, predominantly public sector, workers (social workers, teachers, carers, nurses, etc) or as unpaid workers (unpaid carers: mothers, wives, etc.) but now both forms of work are destabilized and undermined. Thus, the crisis in social reproduction. Within this crisis women’s unequal position is further undermined but at the same time progressive women and men are organizing to present alternatives forms of social reproduction. This presentation by utilizing the case of Greece will first outline the neoliberal processes that have caused the crisis in social reproduction. Second, it will present the consequences of social reproduction by highlighting the gender implications. Third, it will discuss the reorganization of social reproduction which is taking place outside the logic of capitalist society and is manifested through the creation of solidarity health clinics and pharmacies, communal kitchens, creation of various forms of bartering etc. This presentation will argue that these forms present glimpses of another society , a society based on principles of solidarity and cooperation. A society worth fighting for. And finally the presentation will conclude by discussing at which level can this crisis be resolved and the role of the social work profession.