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Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review
Keshani Weragama1, Poonam Mudgil1, John Whitehall1
1Department of Paediatrics, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia.
Antimicrobial stewardship programs (ASPs) effectively reduce antibiotic prescribing in pediatric emergency patients with respiratory symptoms. Multimodal interventions, including education and rapid pathogen testing, showed the most promise for optimizing antibiotic use.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatric Emergency Medicine
Background:
- Antimicrobial resistance is a growing global health crisis.
- Antimicrobial stewardship programs (ASPs) aim to curb unnecessary antibiotic prescriptions.
- Pediatric patients with respiratory symptoms in emergency settings are vulnerable to inappropriate antibiotic use.
Purpose of the Study:
- To systematically review the efficacy and safety of ASPs in pediatric emergency patients with respiratory symptoms.
- To identify effective stewardship interventions for this high-risk population.
- To assess the impact of ASPs on antibiotic prescribing patterns and clinical outcomes.
Main Methods:
- Systematic literature search of major medical databases (PubMed, Medline, EMBASE, Cochrane).
- Inclusion of thirteen studies assessing various ASP interventions and outcomes.
- Review of evidence on the effectiveness and safety of stewardship strategies.
Main Results:
- ASPs significantly reduced antibiotic prescription rates.
- Increased use of narrow-spectrum antibiotics was observed.
- Shorter antibiotic therapy durations were associated with ASP implementation.
- Multimodal, education-based, and rapid respiratory pathogen testing interventions were most effective.
Conclusions:
- ASPs are effective in reducing antibiotic prescribing in pediatric emergency settings.
- Further research is needed to confirm if reduced prescribing translates to equivalent clinical outcomes.
- Targeted ASPs are crucial for managing antibiotic use in vulnerable pediatric populations.
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