Antimicrobial stewardship programs in freestanding children's hospitals

Area of Science:

• Pediatric Infectious Diseases
• Healthcare Quality Improvement
• Antimicrobial Resistance

Background:

• Limited data exist on the effectiveness of pediatric antimicrobial stewardship programs (ASPs).
• Previous single-center studies suggest ASPs improve antibiotic prescribing.
• Formalized ASPs in children's hospitals require further evaluation.

Purpose of the Study:

• To compare antibiotic prescribing rates in pediatric hospitals with formalized ASPs (ASP+) versus those without (ASP-).
• To assess the impact of ASP implementation on antibiotic use over time.
• To evaluate the influence of national guidelines on ASP effectiveness.

Main Methods:

• A comparative study of 31 freestanding children's hospitals (9 ASP+, 22 ASP-) from 2004 to 2012.
• Antibiotic prescribing measured by days of therapy/1000 patient-days.
• Interrupted time series analysis used to determine changes in antibiotic use before and after ASP implementation.

Main Results:

• Hospitals with ASPs showed a greater decline in overall antibiotic use (11%) compared to non-ASP hospitals (8%) after 2007 guideline release (P = .04).
• Individually, 8 of 9 ASP+ hospitals demonstrated reduced antibiotic prescribing.
• Significant average monthly declines in antibiotic use were observed (5.7% overall, 8.2% for select antibiotics).

Conclusions:

• Formalized pediatric antimicrobial stewardship programs are effective in reducing antibiotic prescribing.
• Implementation of ASPs in children's hospitals leads to measurable improvements in antibiotic use.
• These findings support the widespread adoption of ASPs in pediatric settings.