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Antibiotic stewardship programmes had a low impact on prescribing for acute respiratory tract infections in children
1Centre for Child Health Research, Faculty of Medicine and Life Sciences, University of Tampere and University Hospital, Tampere, Finland.
Insights
Antibiotic stewardship programmes (ASPs) showed limited impact on overall antibiotic prescribing for pediatric respiratory infections. However, ASPs modestly reduced broad-spectrum antibiotic use, indicating a need for improved implementation strategies.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Public Health
Background:
- Acute respiratory tract infections (ARTIs) are common in children, leading to significant antibiotic use.
- Antibiotic stewardship programmes (ASPs) aim to optimize antibiotic prescribing and combat antimicrobial resistance.
- Data on ASP implementation and impact in pediatric outpatients for ARTIs is evolving.
Purpose of the Study:
- To review available data on the implementation and impact of antibiotic stewardship programmes (ASPs) for acute respiratory tract infections (ARTIs) in pediatric outpatients.
- To assess the effectiveness of ASPs in influencing antibiotic prescription rates and the use of broad-spectrum antibiotics.
Main Methods:
- A systematic literature search was conducted on PubMed for studies published between January 2012 and December 2021.
- Keywords included 'respiratory tract infection,' 'antibiotic,' 'child,' and 'guideline,' with further refinement for 'impact,' 'implementation,' or 'stewardship.'
- Ten English-language papers focusing on outpatient pediatric ARTIs and ASP data were included.
Main Results:
- ASP implementation did not significantly alter overall antibiotic prescription rates in primary care settings (US data).
- A notable decrease in broad-spectrum antibiotic use was observed (43-48% in primary care, 63-71% in emergency departments).
- Emergency department data (France) and a nationwide study (France) showed significant reductions in overall and broad-spectrum antibiotic prescriptions.
Conclusions:
- ASPs demonstrate a modest impact on reducing broad-spectrum antibiotic prescribing for pediatric ARTIs.
- Further development in the implementation of ASP protocols is required.
- Additional research is needed to understand and overcome barriers to ASP compliance.
Aim:
This mini review summarises the available data on antibiotic stewardship programmes (ASP) for acute respiratory tract infections (ARTI) in paediatric outpatients, particularly the implementation and impact of programmes.
Methods:
PubMed was searched from 1 January 2012 to 31 December 2021 for papers with abstracts that used the terms respiratory tract infection, antibiotic, child and guideline. We then saw how many of these included the individual terms impact, implementation or stewardship. After exclusions, we included 10 papers that were published in English on children treated as outpatients for ARTIs. All of these included data on implementing and assessing the impact of ASPs.
Results:
The primary care data were mainly from the United States. The ASP programmes did not influence antibiotic prescription rates, but broad-spectrum antibiotics decreased by 43-48%. The emergency department data were mainly from France and the antibiotic prescription rate decreased by 31-35% and the rate for broad-spectrum antibiotics by 63-71%. A nationwide register-based study from France confirmed these results.
Conclusion:
ASPs had a low impact on overall antibiotic prescription rates and a modest impact on prescribing broad-spectrum antibiotics. The implementation of ASP protocols needs further development, and more research is necessary on barriers to complying with ASPs.
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