First name
Holly
Last name
Maples

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

Prevalence and characteristics of antimicrobial stewardship programs at freestanding children's hospitals in the United States.

Year of Publication

2014

Number of Pages

265-71

Date Published

2014 Mar

ISSN Number

1559-6834

Abstract

<p><strong>BACKGROUND AND OBJECTIVE: </strong>Antimicrobial stewardship programs (ASPs) are a mechanism to ensure the appropriate use of antimicrobials. The extent to which ASPs are formally implemented in freestanding children's hospitals is unknown. The objective of this study was to determine the prevalence and characteristics of ASPs in freestanding children's hospitals.</p>

<p><strong>METHODS: </strong>We conducted an electronic survey of 42 freestanding children's hospitals that are members of the Children's Hospital Association to determine the presence and characteristics of their ASPs. For hospitals without an ASP, we determined whether stewardship strategies were in place and whether there were barriers to implementing a formal ASP.</p>

<p><strong>RESULTS: </strong>We received responses from 38 (91%) of 42. Among responding institutions, 16 (38%) had a formal ASP, and 15 (36%) were in the process of implementing a program. Most ASPs (13 [81%] of 16) were started after 2007. The median number of full-time equivalents dedicated to ASPs was 0.63 (range, 0.1-1.8). The most common antimicrobials monitored by ASPs were linezolid, vancomycin, and carbapenems. Many hospitals without a formal ASP were performing stewardship activities, including elements of prospective audit and feedback (9 [41%] of 22), formulary restriction (9 [41%] of 22), and use of clinical guidelines (17 [77%] of 22). Antimicrobial outcomes were more likely to be monitored by hospitals with ASPs (100% vs 68%; P = .01), although only 1 program provided support for a data analyst.</p>

<p><strong>CONCLUSIONS: </strong>Most freestanding children's hospitals have implemented or are developing an ASP. These programs differ in structure and function, and more data are needed to identify program characteristics that have the greatest impact.</p>

DOI

10.1086/675277

Alternate Title

Infect Control Hosp Epidemiol

PMID

24521592

WATCH THIS PAGE

Subscription is not available for this page.