Impact of age on antimicrobial prescriptions in hospitalized children at three academic centres in South Africa: a point prevalence survey.

This article analyzes the impact of age on antimicrobial prescribing practices in hospitalized children across three South African academic hospitals, using data from a point prevalence survey (PPS). It finds that neonates and infants receive more antimicrobial prescriptions per patient, with a higher use of WHO-classified Watch antibiotics—particularly carbapenems—compared to older children. The incidence risk ratio of healthcare-associated infections (HAIs) is significantly greater in neonates, infants, and adolescents than in children aged 6–12 years, with risk factors including HIV infection, prolonged hospital stay, surgery, blood transfusion, prematurity, and underweight status. The study highlights the need for age-specific antimicrobial stewardship and surveillance to address the increased use of broad-spectrum antibiotics and to optimize prophylactic antimicrobial use in pediatric hospital settings.