Pharmacovigilance Activities for the Early Detection of Drug-Related Problems (DRPs) on Antibiotic Therapy in Hospitalized Pediatric Patients an Integral Part of an Antimicrobial Stewardship Program (ASP)

Aim/Objective: To demonstrate the detection and analysis of drugrelated problems on antibiotics prescribed to hospitalized pediatric patients as part of an ASP and their impact on patient safety. Methods: Descriptive study of the maneuver of the pharmaceutical audit/feedback interventions carried out prospectively in the period from January to December 2023, where the appropriateness of antibiotics prescribed to hospitalized patients in the Hemato-oncology service of the Federico Go´mez Children's Hospital of Mexico was evaluated through the review of physical and electronic records in conjunction with the information provided by the health professionals in charge of the patients. Following the evaluation of the appropriateness of the prescription, the pertinent recommendation/feedback actions were emitted. Results: The appropriateness of 1014 prescribed antibiotics for 395 hospitalized patients in the Hemato-oncology service of the Federico Go´mez Children's Hospital in Mexico was evaluated, corresponding to 464 infectious events. A total of 224 drug-related problems were found, of which 82 were subtherapeutic doses (36.6%), 62 were antibiotic discontinuations (27.6%) due to unnecessary treatment, 43 were related to supra-therapeutic doses (19.1%), 12 involved antibiotic changes (5.3%), 8 were antibiotic discontinuations due to process errors (3.5%), 7 were due to incorrect administration frequency (3.1%), 7 were related to a new indication of antibiotic(3.1%), 2 were due to incorrect treatment duration (0.89%), and 1 was related to epidemiological notification (0.44%). Of these, 148 pharmaceutical interventions were accepted by the prescriber (66.1%), 47 were rejected (20.9%), and 29 were not carried out (12.9%). Conclusion: Antibiotic use-related problems were found in a substantial proportion of hospitalized pediatric patients, mainly those related with dose selection and treatment duration. Considering the impact of drug-related problems on morbidity, mortality, hospital stay and economic burden, multidisciplinary efforts are critical for the implementation of pharmaceutical interventions as an essential part of an antimicrobial stewardship program. Antibiotic use-related problems were found in a substantial proportion of hospitalized pediatric patients, mainly those related with dose selection and treatment duration. Considering the impact of drug-related problems on morbidity, mortality, hospital stay and economic burden, multidisciplinary efforts a