The following is a summary of “The Impact of a Multifaceted Tertiary Pediatric Hospital’s Antimicrobial Stewardship Service” published in the December 2022 issue of Pediatric Infectious Disease by Goff et al.
When it comes to medication for kids, antimicrobials are always first on the list. The World Health Organization ranks antimicrobial resistance as one of the top 10 dangers to world health, with overuse due to incorrect prescribing as a major driver of the problem. When an extensive Antimicrobial Stewardship (AMS) program was implemented, a prospective observational cohort study was conducted to see how well it was working (January 2014 to December 2020). Patient information sources and physicians directly accountable for patient care were mined for data on ambulatory monitoring systems (AMS) and “handshake” ward rounds.
Therapy appropriateness (drug, dose, antimicrobial spectrum, duration, and route), prescription guideline adherence, antimicrobial expenditure, usage of high-priority antimicrobials, and length of hospital stay are all primary outcomes. Results were examined over 3 time periods: January 2014–December 2015; January 2016–December 2017; and January 2018–December 2020. From 6111/7040 (79.4%) in the first 2 years after AMS program introduction to 17,819/19,229 (92.3%), the appropriateness of individual antimicrobial orders increased across study periods. In addition, a rise in the percentage of people who followed the guidelines, from 5,426 to 19,316 (70.5% to 92.3%), is very encouraging.
Over the span of study, total spending on antimicrobials decreased by 34%, or $12.52 per bed day, and spending on antifungals decreased by 37%, or $5.56 per bed day. This research measures the long-term effects of a comprehensive pediatric AMS program on lowering the wasteful use of antibiotics and raising the rate of adherence to recommendations. These strategies have been shown to help reduce unnecessary antimicrobial use in children, and so they should be considered by any organization serious about making a difference in this area.