Use of antibiotics in pediatric intensive care and potential savings.

OBJECTIVE: Minimizing unwarranted prescription of antibiotics remains an important objective. Because of the heterogeneity between units regarding patient mix and other characteristics, site-specific targets for reduction must be identified. Here we present a model to address the issue by means of an observational cohort study. SETTING: A tertiary, multidisciplinary, neonatal, and pediatric intensive care unit of a university teaching hospital. PATIENTS: All newborns and children present in the unit (n = 456) between September 1998 and March 1999. Reasons for admission included postoperative care after cardiac surgery, major neonatal or pediatric surgery, severe trauma, and medical conditions requiring critical care. METHODS: Daily recording of antibiotics given and of indications for initiation. After discontinuation, each treatment episode was assessed as to the presence or absence of infection. RESULTS: Of the 456 patients 258 (56.6%) received systemic antibiotics, amounting to 1815 exposure days (54.6%) during 3322 hospitalization days. Of these, 512 (28%) were prescribed as prophylaxis and 1303 for suspected infection. Treatment for suspected ventilator-associated pneumonia accounted for 616 (47%) of 1303 treatment days and suspected sepsis for 255 days (20%). Patients were classified as having no infection or viral infection during 552 (40%) treatment days. The average weekly exposure rate in the unit varied considerably during the 29-week study period (range: 40-77/100 hospitalization days). Patient characteristics did not explain this variation. CONCLUSION: In this unit the largest reduction in antibiotic treatment would result from measures assisting suspected ventilator-associated pneumonia to be ruled out and from curtailing extended prophylaxis.

HSC Pension (PDF 442 KB)

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Public Service Agreement - Health Sector Progress Report and Savings - May 2011

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Public Service Agreement 2010-2014 (Croke Park Agreement) - Second Annual Progress, Savings and Productivity Reports for the Department and its Agencies

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Public Service Agreement 2010-2014 (Croke Park Agreement) - Third Annual Progress and Savings Report for the Department and its Agencies

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Iowa Department of Transportation Fiscal Year 2002 Report of Savings by Using Videoconferencing through Iowa Communications Network to the Iowa General Assembly, 2002

ICN Videoconferencing by the Iowa Department of Transportation

Iowa Department of Transportation Fiscal Year 2003 Report of Savings by Using Videoconferencing Through Iowa Communications Network, Iowa Department of Transportation, December 2003

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Office of Treasurer of State Iowa Educational Savings Plan Trust, June 30, 2002

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Office of Treasurer of State, Iowa Educational Savings Plan Trust, June 30, 2003

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Office of Treasurer of State Iowa Educational Savings Plan Trust, Independent Auditor's Reports Financial Statements and Supplementary Information, June 30, 2004

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Iowa Department of Transportation Fiscal Year 2004 Report of Savings by Using Videoconferencing Through Iowa Communications Network, Iowa Department of Transportation, December 2004

Iowa DOT savings through use of Iowa Communcations Network (ICN) videoconferencing

Office of Treasurer of State Iowa Educational Savings Plan Trust Independent Auditor's Reports Finanical Statements and Supplementary Information, June 30, 2005.

Office of Treasurer of State, Iowa Educational Savings Plan Trust (Trust) for the year ended June 30, 2005. Independent Auditor's Report, Financial Statements and Supplementary Information.