Multinational consensus antimicrobial stewardship recommendations for children managed in hospital settings
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Updated: Aug 16, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Brendan McMullan1, Penelope A Bryant2, Eamon Duffy3
1Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Immunology, Sydney Children's Hospital Randwick, Sydney, NSW, Australia; Department of Infectious Diseases, Sydney Children's Hospital Randwick, Sydney, NSW, Australia.
Insights
Hospital antimicrobial stewardship (AMS) programs need to include children. This study developed ten evidence-based recommendations for pediatric AMS to ensure children receive optimal antibiotic therapy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Children's antibiotic therapy may be overlooked in hospital antimicrobial stewardship (AMS) programs.
- Pediatric patients are a smaller proportion of hospital admissions and cared for by specialized staff.
Purpose of the Study:
- To develop evidence-based recommendations for hospital AMS programs specifically for children.
- To improve the quality of antibiotic therapy for pediatric patients.
Main Methods:
- Systematic review of scientific literature on pediatric AMS (2007-2019).
- Consultation with a multinational expert group from North America, Europe, and Oceania.
- Survey of healthcare workers on the importance and feasibility of recommendations.
Main Results:
- Ten recommendations for good-practice in pediatric hospital AMS programs were developed.
- Recommendations were deemed very important and generally feasible by surveyed healthcare workers.
- The developed recommendations aim to guide best-practice care for children.
Conclusions:
- Implementation of these recommendations can enhance antibiotic therapy for children.
- Further research is needed to continually improve pediatric AMS.
- Integrating pediatric considerations into AMS is crucial for equitable and effective patient care.
Abstract:
Children are entitled to receive antibiotic therapy that is based on evidence and best practice, but might be overlooked in hospital programmes designed to achieve antimicrobial stewardship [AMS]. This failure to include children could be because children make up small proportion of patients in most hospitals, and are cared for by specialised paediatric staff. We reviewed the evidence and consulted experts in three global regions to develop ten recommendations for good-practice in hospital AMS programmes for children. We performed a review of scientific research, published between Jan 1, 2007, and Oct 17, 2019, concerning AMS, and formed a multinational expert group comprising members from the USA, Canada, the UK, Belgium, Switzerland, Australia, and Aotearoa New Zealand to develop the recommendations. These recommendations aim to help health-care workers who care for children in these regions to deliver best-practice care. We surveyed health-care workers with expertise in antibiotic therapy for children across these regions, and found that the recommendations were considered both very important and generally feasible. These recommendations should be implemented in hospitals to improve antibiotic therapy for children and to stimulate research into future improvements in care.
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