<p>Pediatric Antimicrobial Stewardship Programs: Current Perspectives</p>

Abstract

With the rapid growth of the field of pediatric antimicrobial stewardship, there has been a marked increase in the establishment of programs dedicated to this specialty. Shared objectives of all pediatric antimicrobial stewardship programs (ASPs) include optimization of antibiotic use and improvement in clinical outcomes for children, while certain core operational strategies and metrics used to measure program effectiveness are typically utilized by pediatric ASPs. Antimicrobial stewardship is the responsibility of every individual who prescribes, dispenses, and administers antibiotics to children, and pediatric ASP principles are rooted in collaboration and cooperation. Pediatric ASPs are uniquely suited to meet the needs of the local populations they serve and the environments within which they practice while also fostering an awareness of the interconnected global nature of pediatric stewardship. As such, pediatric ASPs are well positioned to confront the evolving challenges of antimicrobial overuse and resistance.

Antibiotic consumption among hospitalized neonates and children in Punjab province, Pakistan

“…Surveillance of antimicrobial consumption is essential to evaluate prescribing practices in hospital settings to identify areas for improvement. This could reduce the irrational use of antimicrobials under the umbrella of antimicrobial stewardship programs (ASPs), including prescribing for children (CDC, 2019;Versporten et al, 2018;Saleem et al 2020;Nathwani et al, 2019;Klatte et al, 2020;Dona et al, 2020). Higher-income countries have reported such surveys, but the data from LMICs is more limited due to a lack of sources; however, this is changing (Gandra et al, 2017;Versporten et al2018;Saleem et al 2020;Anand et al, 2019;Skosna et al, 2021;Labi et al, 2019;Abubakar, 2020;Okoth et al, 2018;Saleem et al, 2019B;Seni et al, 2020).…”

Association of Diagnostic Stewardship for Blood Cultures in Critically Ill Children With Culture Rates, Antibiotic Use, and Patient Outcomes

“…Most antimicrobial stewardship efforts include prior authorization to start broadspectrum antibiotics or after prescription review to reduce antibiotic duration of therapy. 33,34 Diagnostic stewardship focuses "upstream" on the decision to send a diagnostic test, when clinicians are still considering if infection is present. Because clinicians often start antibiotics at the time bacterial cultures are ordered, diagnostic stewardship is a complementary strategy to further combat antibiotic overuse.…”

“…Diagnostic stewardship offers important benefits distinct from antimicrobial stewardship. Most antimicrobial stewardship efforts include prior authorization to start broad-spectrum antibiotics or after prescription review to reduce antibiotic duration of therapy . Diagnostic stewardship focuses “upstream” on the decision to send a diagnostic test, when clinicians are still considering if infection is present.…”

Antimicrobial stewardship program in pediatric medicine

“…Methods identified as effective in general inpatient pediatric wards include antimicrobial agent restriction and preauthorization, establishing guidelines for switching from broad‐spectrum to narrow spectrum, or deescalation intravenous to oral antibiotics, prospective audit and feedback, and training and education of healthcare professionals. 48 , 49 However, there is a paucity of literature on ASPs in ICU settings. The ICU is a unique environment where broad‐spectrum antimicrobials are used to empirically cover MDR infections due to the critical status of their patients.…”