Antibiotic surveillance on a paediatric intensive care unit: easy attainable strategy at low costs and resources

Area of Science:

• Pediatric Intensive Care Unit (PICU) antibiotic stewardship
• Infectious disease management
• Healthcare quality improvement

Background:

• Antibiotic surveillance is crucial for optimizing antibiotic therapy.
• Evaluating antibiotic use in a pediatric intensive care unit (PICU) is essential.
• Implementing achievable interventions can improve antibiotic prescribing practices.

Purpose of the Study:

• To evaluate antibiotic use within a PICU.
• To implement a simple, achievable intervention to enhance antibiotic therapy.
• To assess the impact of the intervention on antibiotic prescribing patterns.

Main Methods:

• Prospective surveillance of antibiotic use over 6 months (3 months pre-intervention, 3 months post-intervention).
• Utilized the CDC 12-step campaign for evaluation and intervention development.
• Implemented a mandatory checklist for antibiotic indication, likelihood of infection, and therapy review.

Main Results:

• Appropriate empiric antibiotic therapy for culture-negative symptoms increased from 18% to 74% (p<0.0001).
• Shortened duration of antibiotic therapy (<3 days) increased from 18% to 35% (p=0.05).
• Correct targeting of pathogens improved from 58% to 83% (p=0.21).

Conclusions:

• Antibiotic surveillance, guided by the CDC 12-step campaign, effectively evaluates institutional antibiotic therapy.
• A simple checklist intervention can significantly improve antibiotic use with minimal cost.
• The study demonstrates the feasibility and effectiveness of attainable interventions in PICU antibiotic stewardship.