In an American Academy of Pediatrics policy statement, published in Pediatrics, guidance is provided for inpatient and outpatient antibiotic stewardship. The authors discuss inpatient and outpatient antibiotic stewardship programs (ASPs) in pediatrics, including essential personnel, infrastructure, and activities needed. They note that the American Academy of Pediatrics and Pediatric Infectious Diseases Society recommend establishing ASPs to improve antibiotic prescribing; the ASPs should include specialists with pediatric expertise. Ideally, inpatient ASPs should include a medical director and clinical pharmacist, both with expertise in pediatric infectious diseases and/or antibiotic stewardship. Core interventions for inpatient ASPs can use clinical guidelines, prior approval, and post-prescription review and feedback. Pharmacy-driven interventions can be included in inpatient ASPs. Standardized approaches for antibiotic prescribing, including clinical guidelines and/or decision support, should be considered for outpatient primary care practices, urgent care clinics, and emergency departments. Outpatient stewardship can focus on judicious antibiotic use and can emphasize use of the narrowestspectrum antibiotics for the shortest duration of therapy to adequately treat infections.

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