First name
Ritu
Last name
Banerjee

Title

A National Survey of Outpatient Parenteral Antibiotic Therapy Practices.

Year of Publication

2021

Date Published

2021 Dec 23

ISSN Number

2048-7207

Abstract

<p>We conducted a national survey of pediatric infectious diseases (ID) clinicians on outpatient parenteral antibiotic therapy (OPAT) practices and post-discharge ID follow-up. Only 15% of sites required ID consultation for all OPAT. ID division resources for post-discharge care varied. Opportunities exist to increase ID involvement in post-discharge management of serious infections.</p>

DOI

10.1093/jpids/piab127

Alternate Title

J Pediatric Infect Dis Soc

PMID

34939654

Title

Pediatric antimicrobial stewardship practices at discharge: A national survey.

Year of Publication

2021

Number of Pages

1-3

Date Published

2021 Jul 16

ISSN Number

1559-6834

Abstract

<p>We surveyed pediatric antimicrobial stewardship program (ASP) site leaders within the Sharing Antimicrobial Reports for Pediatric Stewardship collaborative regarding discharge stewardship practices. Among 67 sites, 13 (19%) reported ASP review of discharge antimicrobial prescriptions. These findings highlight discharge stewardship as a potential opportunity for improvement during the hospital-to-home transition.</p>

DOI

10.1017/ice.2021.283

Alternate Title

Infect Control Hosp Epidemiol

PMID

34269167

Title

Epidemiology of Staphylococcus aureus infections in patients admitted to freestanding pediatric hospitals, 2009-2016.

Year of Publication

2018

Number of Pages

1-4

Date Published

2018 Oct 29

ISSN Number

1559-6834

Abstract

<p>We observed pediatric S. aureus hospitalizations decreased 36% from 26.3 to 16.8 infections per 1,000 admissions from 2009 to 2016, with methicillin-resistant S. aureus (MRSA) decreasing by 52% and methicillin-susceptible S. aureus decreasing by 17%, among 39 pediatric hospitals. Similar decreases were observed for days of therapy of anti-MRSA antibiotics.</p>

DOI

10.1017/ice.2018.259

Alternate Title

Infect Control Hosp Epidemiol

PMID

30370879

Title

Expanding Existing Antimicrobial Stewardship Programs in Pediatrics: What Comes Next.

Year of Publication

2017

Date Published

2017 Dec 18

ISSN Number

2048-7207

Abstract

<p>The prevalence of pediatric antimicrobial stewardship programs (ASPs) is increasing in acute care facilities across the United States. Over the past several years, the evidence base used to inform effective stewardship practices has expanded, and regulatory interest in stewardship programs has increased. Here, we review approaches for established, hospital-based pediatric ASPs to adapt and report standardized metrics, broaden their reach to specialized populations, expand to undertake novel stewardship initiatives, and implement rapid diagnostics to continue their evolution in improving antimicrobial use and patient outcomes.</p>

DOI

10.1093/jpids/pix104

Alternate Title

J Pediatric Infect Dis Soc

PMID

29267871

Title

The Role of Stewardship in Addressing Antibacterial Resistance: Stewardship and Infection Control Committee of the Antibacterial Resistance Leadership Group.

Year of Publication

2017

Number of Pages

S36-S40

Date Published

2017 Mar 15

ISSN Number

1537-6591

Abstract

<p>Antibacterial resistance is increasing globally and has been recognized as a major public health threat. Antibacterial stewardship is the coordinated effort to improve the appropriate use of antibiotics with the aim to decrease selective pressure for multidrug-resistant organisms in order to preserve the utility of antibacterial agents. This article describes the activities of the Antibacterial Resistance Leadership Group (ARLG) in the area of antibacterial stewardship. To date, the ARLG has focused intensely on development of rapid diagnostic tests, which (when coupled with educational and institutional initiatives) will enable the robust stewardship that is needed to address the current crisis of antibacterial resistance. In addition to exploring the effectiveness of stewardship techniques in community hospitals, the ARLG has also developed strategy trials to assess the feasibility of reducing antibacterial usage while preserving patient outcome.</p>

DOI

10.1093/cid/ciw830

Alternate Title

Clin. Infect. Dis.

PMID

28350902

Title

Antimicrobial stewardship in pediatric care: strategies and future directions.

Year of Publication

2012

Number of Pages

735-43

Date Published

2012 Aug

ISSN Number

1875-9114

Abstract

<p>Antimicrobial stewardship programs (ASPs) are an effective strategy for improving the quality and safety of antimicrobial prescribing for hospitalized patients. Pediatric ASPs are in their early stages of development, and there are unique issues relevant to children. The imperative to ensure that antimicrobials are prescribed judiciously is highlighted by the ongoing epidemic increase in antimicrobial-resistant infections and the simultaneous decline in the rate of new drug development. In this review we describe the process of ASP development for pediatrics, review existing data regarding the impact of pediatric ASPs, and describe the priorities and challenges for ASP research including study design and appropriate end points.</p>

DOI

10.1002/j.1875-9114.2012.01155.x

Alternate Title

Pharmacotherapy

PMID

23307521

Title

The use of intravenous colistin among children in the United States: results from a multicenter, case series.

Year of Publication

2013

Number of Pages

17-22

Date Published

2013 Jan

ISSN Number

1532-0987

Abstract

<p><strong>BACKGROUND: </strong>A rapid increase in multidrug-resistant Gram-negative infections has led to a reemergence of colistin use globally. Although it is well described among adults, colistin use and its associated toxicities in children are poorly understood. We report findings from the largest case series of pediatric colistin use to date.</p>

<p><strong>METHODS: </strong>We queried pediatric infectious diseases specialists from the Emerging Infections Network to identify members who had prescribed intravenous colistin within the past 7 years. We collected relevant demographic and clinical data. Bivariate analyses and multivariable logistic regression were performed.</p>

<p><strong>RESULTS: </strong>Two hundred twenty-nine pediatric infectious diseases specialists completed the survey (84% response); 22% had prescribed colistin to children. Among respondents, 92 cases of colistin use from 25 institutions were submitted. The most commonly targeted organisms were multidrug-resistant Pseudomonas (67.4%), multidrug-resistant Acinetobacter -baumanii (11.9%), carbapenemase-producing Enterobacteriaceae (13.0%) and extended-spectrum β-lactamase producing Enterobacteriaceae (5.4%). Development of resistance to colistin was observed in 20.5% of patients. Additional antimicrobial therapy was administered to 84% of patients, and 22% of children experienced nephrotoxicity (not associated with dosage or interval of colistin prescribed). Renal function returned to baseline in all patients. Children aged ≥13 years had approximately 7 times the odds of developing nephrotoxicity than younger children, even after controlling for receipt of additional nephrotoxic agents (odds ratio 7.16; 95% confidence interval: 1.51-14.06; P = 0.013). Four children exhibited reversible neurotoxicity.</p>

<p><strong>CONCLUSIONS: </strong>Most pediatric infectious diseases specialists have no experience prescribing colistin. Colistin use in children has been associated primarily with nephrotoxicity and, to a lesser extent, neurotoxicity, both of which are reversible. Emergence of resistance to colistin is concerning.</p>

DOI

10.1097/INF.0b013e3182703790

Alternate Title

Pediatr. Infect. Dis. J.

PMID

22935871

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