Effectiveness of a Pediatric Antimicrobial Stewardship Program in a Community Hospital

Antimicrobial stewardship (ASP) programs are an essential way to improve the use of antimicrobials, as well as an optimal care routine for a pediatric population. However, developing a successful program is challenging in non-academic centers due to limited resources and a lack of infectious disease experts.

Researchers at the Sutter Medical Center in Sacramento recently used an antimicrobial stewardship program with a core strategy of custom pre-authorization and post-prescription audit and intervention assessment to assess its effectiveness in a community pediatric hospital.

The data was presented at the 23rd annual virtual sessions of Making a Difference in Infectious Disease Meeting 2021.

The researchers conducted the program at the Sutter Medical Center, a 516-bed hospital with a 40-bed pediatric unit and a 20-bed pediatric intensive care unit (PICU).

The pilot program took place between January 19 and February 5, 2021. A team was formed with a pediatrician ASP physician, a senior ID pharmacist, a PICU pharmacist and a pharmacy resident.

The team provided standard stewardship services using a prospective audit with feedback plan. The team compared the days of antibiotic therapy during the pilot phase with antibiotic days of therapy in pediatric patients admitted from January 1 to December 31.

The stewardship interventions were monitored and categorized as de-escalation, withdrawal, dose optimization, duration of therapy, drug erroneous bug, IV-to-PO, and therapeutic monitoring.

The program’s findings showed that 55 out of 68 patient cases required pharmacist intervention. Days of antibiotic therapy were found to decrease from 3.95 days to 2.16 days during the pilot period.

In addition, the most common procedure was discontinuation by a pharmacist. About 73% of the interventions were accepted by pediatricians.

“Data on pediatric AS program in a community hospital is limited. Most studies were conducted from independent children’s hospitals. We are demonstrating the pilot of an AS initiative with limited resources at the community hospital, significantly reducing antibiotic days, ”the authors wrote. “The results of this pilot project suggest that the community hospital can improve the use of antimicrobials and achieve optimal care for pediatric patients, despite limited resources.”

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