Email updates

Keep up to date with the latest news and content from BMC Infectious Diseases and BioMed Central.

Open Access Research article

Current ciprofloxacin usage in children hospitalized in a referral hospital in Paris

Zhi-Tao Yang126, Jean-Ralph Zahar23, Fréderic Méchaï12, Martine Postaire4, Stéphane Blanot5, Sarah Balfagon-Viel12, Xavier Nassif23 and Olivier Lortholary12*

Author Affiliations

1 Service des Maladies Infectieuses et Tropicales & Centre d’Infectiologie Necker-Pasteur, Université Paris Descartes, Hôpital Necker-Enfants Malades, Paris, France

2 Equipe mobile d’infectiologie, Hôpital Necker-Enfants Malades, Paris, France

3 Service Microbiologie–Hygiène Hospitalière, Hôpital Necker-Enfants Malades, Paris, France

4 Service Pharmacie, Hôpital Necker-Enfants malades, Paris, France

5 Service d’Anesthésie, Hôpital Necker-Enfants malades, Paris, France

6 First author: Emergency department, Pôle Sino-Français de Recherche en Science du Vivant et Génomique, Ruijin Hospital in Shanghai, No 197, Ruijin Er Road, Shanghai 200025, China

For all author emails, please log on.

BMC Infectious Diseases 2013, 13:245  doi:10.1186/1471-2334-13-245

Published: 27 May 2013

Abstract

Background

Fluoroquinolones are used with increasing frequency in children with a major risk of increasing the emergence of FQ resistance. FQ use has expanded off-label for primary antibacterial prophylaxis or treatment of infections in immune-compromised children and life-threatening multi-resistant bacteria infections. Here we assessed the prescriptions of ciprofloxacin in a pediatric cohort and their appropriateness.

Methods

A monocenter audit of ciprofloxacin prescription was conducted for six months in a University hospital in Paris. Infected site, bacteriological findings and indication, were evaluated in children receiving ciprofloxacin in hospital independently by 3 infectious diseases consultants and 1 hospital pharmacist.

Results

Ninety-eight ciprofloxacin prescriptions in children, among which 52 (53.1%) were oral and 46 (46.9%) parenteral, were collected. 45 children had an underlying condition, cystic fibrosis (CF) (21) or an innate or acquired immune deficiency (24). Among CF patients, the most frequent indication was a broncho-pulmonary Pseudomonas aeruginosa infection (20). In non-CF patient, the major indications were broncho-pulmonary (25), urinary (8), intra-abdominal (7), operative site infection (5) and bloodstream/catheter (2/4) infection. 62.2% were microbiologically documented. Twenty-three (23.4%) were considered “mandatory”, 48 (49.0%) “alternative” and 27 (27.6%) “unjustified”.

Conclusion

In our university hospital, only 23.4% of fluoroquinolones prescriptions were mandatory in children, especially in Pseudomonas aeruginosa healthcare associated infection. Looking to the ecological risk of fluoroquinolones and the increase consumption in children population we think that a control program should be developed to control FQ use in children. It could be done with the help of an antimicrobial stewardship team.

Keywords:
Ciprofloxacin; Children; Cystic fibrosis; Appropriate prescription