Pediatric Antibiotic Stewardship for Community-Acquired Pneumonia: A Pre-Post Intervention Study
Herman Avner Cohen1,2, Maya Gerstein1,2, Yiska Loewenberg Weisband3
1Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
Insights
An antibiotic stewardship program (ASP) significantly reduced azithromycin use in children with community-acquired pneumonia (CAP), increasing adherence to guidelines for safer antibiotic prescribing.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Community-acquired pneumonia (CAP) is a common childhood illness.
- Antibiotic overuse contributes to antimicrobial resistance.
- Effective antibiotic stewardship programs (ASPs) are crucial for optimizing antibiotic use.
Purpose of the Study:
- To evaluate the impact of an ASP intervention on antibiotic prescribing patterns for pediatric CAP.
- To assess changes in the use of specific antibiotics, such as azithromycin and amoxicillin.
- To determine if the intervention improved adherence to national treatment guidelines.
Main Methods:
- A quasi-experimental study design comparing antibiotic purchasing data before and after an ASP intervention.
- Data collected for children aged 3 months to 18 years diagnosed with CAP.
- Intervention involved a 1-day seminar for pediatricians on CAP diagnosis and treatment guidelines.
Main Results:
- A substantial decrease in azithromycin use was observed post-intervention.
- Younger children showed a 42% decrease in azithromycin use, with increased amoxicillin use (P < .001).
- Older children had a smaller, non-significant decrease in azithromycin use (P = .45).
Conclusions:
- Implementation of an ASP was associated with reduced use of broad-spectrum antibiotics and macrolides.
- The ASP intervention led to increased guideline adherence for pediatric CAP treatment.
- ASPs are effective in promoting safer and more appropriate antibiotic prescribing in children.
Abstract:
We aimed to investigate the effectiveness of an antibiotic stewardship program (ASP) on antibiotic prescription in children with community-acquired pneumonia (CAP). Antibiotic purchasing data were collected for children aged 3 months to 18 years diagnosed with CAP from November 2016 to April 2017 (pre-intervention period) and from November 2017 to April 2018 (post-intervention period). The intervention was a 1-day seminar for primary care pediatricians on the diagnosis and treatment of CAP in children according to national guidelines. There was a substantial decrease in the use of azithromycin after the intervention. In younger children, there was a 42% decrease, alongside an increased use of amoxicillin (P < .001). In older children, there was a smaller, non-statistically significant decrease in the use of azithromycin (P = .45). Our data demonstrate that the implementation of an ASP was associated with a reduction in the use of broad-spectrum antibiotics and macrolides and increased guideline adherence for the safe treatment of CAP.
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