Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports
Christopher McPherson1,2, Brian R Lee3, Cindy Terrill4
1Department of Pharmacy, St. Louis Children's Hospital, 1 Children's Place, St. Louis, MO 63110, USA. mcpherson_c@kids.wustl.edu.
Insights
Most US children's hospitals have antimicrobial stewardship programs (ASP) with core elements. While physician accountability and drug expertise are common, resource variability exists, highlighting the need for further expansion and outcome research.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatric Healthcare
Background:
- Antibiotic resistance is a growing global health threat.
- Antimicrobial stewardship programs (ASP) are crucial for combating resistance.
- Rapid implementation of ASPs in US healthcare settings is observed.
Purpose of the Study:
- To assess the prevalence of the Centers for Disease Control and Prevention's (CDC) seven core elements of successful ASPs in US children's hospitals.
- To identify variations in the implementation and resources of pediatric ASPs.
- To compare current findings with previous surveys on pediatric stewardship programs.
Main Methods:
- A survey was conducted in 2016 among 52 pediatric hospitals in the US.
- The survey assessed the presence of seven core ASP elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education.
- Data on established ASPs and their components were collected and analyzed.
Main Results:
- 49 out of 52 (94%) hospitals surveyed had established ASPs.
- 41 out of 52 (79%) hospitals reported implementing all seven core elements.
- Physician accountability (87%) and dedicated ASP pharmacist/drug expert (88%) were highly prevalent, but financial support varied significantly.
- Variability in financial support did not correlate with program actions, tracking, reporting, or education.
Conclusions:
- There has been a significant increase in the prevalence and resources of pediatric ASPs in the US.
- Continued expansion and resource allocation for pediatric stewardship programs are warranted.
- Further research is needed to understand the feasibility of stewardship activities and their impact on patient outcomes within resource constraints.
Abstract:
In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention's (CDC) seven core elements of a successful ASP within a large subset of US Children's Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a dedicated ASP pharmacist or drug expert (88%) were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.
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