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Antibiotic Resistance and Prescribing in European Children [ARPEC] [20091101] - Project
General objectives

The general objective of the project is to improve the quality of antibiotic prescribing for children in Europe. The specific objectives include determining the variation in antibiotic prescribing for common childhood infections in the community and hospitals across Europe, compared to local guidelines. The project will also systematically compare rates of antimicrobial resistance. There has been a limited focus on education on antimicrobial resistance on pediatricians. The project will aim to kick start a new network of PID specialists working in close collaboration and building on the existing EU funded surveillance projects. ARPEC will use key opinion leaders within ESPID to try to develop the evidence base for the variation in antibiotic resistance and prescribing. This will then directly translate into long term educational programmes focussing on trainee pediatricians and formalise educational training packages in prudent antimicrobial prescribing.

Strategic relevance and contribution to the public health programme

The World Heath Assembly of 1998 urged member states to develop sustainable systems to monitor volumes and patterns of antimicrobials, detect resistant pathogens and improve educational programmes encouraging prudent antimicrobial use. The project will build on the ESAC and EARSS programmes, working with the ECDC to develop a sustainable surveillance and educational programme for antimicrobial prescribing and antibiotic resistance in children. The core focus of the project is the optimisation of antimicrobial prescribing for children in Europe and this remains a key part of the ECDC work plan. The aim of this first phase of the project is to make the long term routine data collection self-sustainable from participating countries, with the future focus being on the optimal educational methodologies to reduce inappropriate prescribing.

Methods and means

The project will determine the variation in drug, dose and indications for community and hospital antibiotic prescribing for common childhood infections between EU countries. For community pediatric prescribing variation in both overall and antibiotic class-specific rates will be determined between countries. The programme will produce a novel pediatric defined daily dose (DDD) methodology and conduct an EU-wide point prevalence survey to compare antibiotic use in children in hospital. Using established EARSS methodology, information on bacteremia rates and antimicrobial susceptibility patterns for selected common pathogens in Europe will be collected for major children`s hospitals in Partner countries.
ARPEC will feed back the project results through regional meetings and use an established web-based methodology for a new ESPID educational training programme on prudent prescribing.

Expected outcomes period

The PPS study would provide for the first time detailed indication and age specific hospital prescribing data on antibiotics for medical and surgical treatment and prophylaxis. Key Outcome: Direct comparison data on hospital antibiotic prescribing practice that can be fed directly back to prescribers.
The Antimicrobial resistance work package will identify resistance rates for specific pathogens to selected antibiotics in children. 2 key outcomes will be: 1)identify trends in penicillin-resistant pneumococci between countries following introduction of conjugate pneumococcal vaccine across Europe as the date of introduction, the schedule and uptake of this vaccine vary significantly. 2) determination of the spread of multi-resistant gram negative pathogens in community and hospitals in Europe.
Community antibiotic prescribing for common childhood infections WP. Key outcome: differences in actual prescribed antibiotics for specific countries compared to their guidelines. This data will provide the basis for future intervention programmes to reduce inappropriate antibiotic prescribing.

Details
Start date: 01/09/2010
End date: 01/01/2014
Duration: 40 month(s)
Current status: Finalised
Programme title: Second Programme of Community action in the Field of Health 2008-2013
EC Contribution: € 683 048,75