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Updated: Nov 12, 2025
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
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Antimicrobial stewardship experience in paediatrics: first-year activity report.
Erika Silvestro1, Raffaella Marino2, Francesca Cusenza2
1Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy. esilvestro@cittadellasalute.to.it.
Summary
Implementing a paediatric antimicrobial stewardship program effectively reduced inappropriate antibiotic use in a children's hospital. This strategy helps preserve essential antibiotics for public health by optimizing antimicrobial prescribing practices.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatric Medicine
Background:
- Antimicrobial resistance poses a significant global public health threat.
- Antimicrobial stewardship programs (ASPs) are crucial for preserving antibiotic efficacy.
- ASPs have been implemented in adult and pediatric care since 2007.
Purpose of the Study:
- To describe the initial implementation and outcomes of a pediatric antimicrobial stewardship program.
- To evaluate the impact of a stewardship team on antibiotic prescribing in a children's hospital.
Main Methods:
- Retrospective observational study in a tertiary care children's hospital.
- A multidisciplinary team (microbiologist, infectious diseases physician, pediatrician) conducted prospective audits.
- Interventions included antibiotic discontinuation, step-up/step-down, and spectrum adjustments based on culture results and patient data.
Main Results:
- 192 interventions were made from 584 reviews, with 76.0% recommending antibiotic discontinuation.
- Antibiotic spectrum was more frequently narrowed than broadened (p < 0.0001).
- Interventions were most impactful for documented infections and surgical patients, with 85.9% team compliance.
Conclusions:
- Pediatric antimicrobial stewardship programs are effective in enhancing appropriate antimicrobial use.
- This approach supports the preservation of the antibiotic armamentarium against resistance.
- The study highlights the successful integration of stewardship principles in pediatric care.
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