Related Experiment Video
Updated: Jul 8, 2025
Author Spotlight: Understanding and Detecting Environmental Antimicrobial Resistance by Combining Culture-Based Techniques and Genomics
Published on: July 19, 2024
Enforcing surveillance of antimicrobial resistance and antibiotic use to drive stewardship: experience in a
A Zaffagnini1, E Rigotti2, F Opri2
1Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy.
Insights
This study shows that an electronic App-based antibiotic stewardship intervention in paediatrics significantly reduced antimicrobial consumption and improved prescription appropriateness. The findings highlight the value of digital tools in enhancing guideline adherence and sustaining positive outcomes in pediatric antibiotic use.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Digital Health Interventions
Background:
- Paediatric antibiotic stewardship (AS) interventions lack standardized methodologies and outcome metrics.
- This study evaluated an AS intervention utilizing education and guideline provision via an electronic App.
Purpose of the Study:
- To assess the impact of an electronic App-based AS intervention on antibiotic consumption and prescription appropriateness in paediatrics.
- To evaluate secondary outcomes including length of stay, readmission rates, and antimicrobial resistance (AMR).
Main Methods:
- An interrupted time series analysis compared antibiotic consumption in 2022 (post-intervention) with 2019 (control).
- The intervention involved observation, education, audit/feedback, and use of the Firstline.org App.
- Data collected included prescription appropriateness, length of stay, readmissions, and AMR prevalence.
Main Results:
- Significant reductions in antibiotic consumption (DDD/1000 patient days: -222.13; DOT/1000 patient days: -452.49) were observed post-intervention.
- Prescription appropriateness reached 85.7% with a stable trend.
- 30-day readmission rates decreased significantly (4.9% to 2.8%), while other secondary outcomes remained stable.
Conclusions:
- The electronic App-based AS intervention effectively reduced antimicrobial consumption and improved prescription appropriateness in paediatric care.
- Digital tools are valuable for promoting guideline adherence and ensuring the long-term sustainability of AS program results.
Background:
Antibiotic stewardship (AS) interventions in paediatrics are still not standardized regarding methodology, metrics, and outcomes. We report the results of an AS intervention in the paediatric area based on education and guideline provision via an electronic App.
Materials And Methods:
The AS intervention was conducted in 2021 through observation, education, audit and feedback and provision of an electronic App (Firstline.org) to support antibiotic prescription based on local susceptibility data. The primary outcome was the antibiotic consumption in the 12 months following the intervention (year 2022) compared with a historical 12-month control (year 2019) via an interrupted time series analysis. Secondary outcomes were appropriateness of therapy, length of stay, 30-day readmission, transfers to the paediatric intensive care unit, in-hospital mortality, and prevalence of antimicrobial resistance (AMR).
Results:
During the post-intervention phase, 29 cross-sectional audits and feedback were conducted including 467 patients. Prescriptions were appropriate according to the guidelines in 85.7% of cases, with a stable trend over time. A significant decrease in antibiotic consumption was measured in terms of defined daily doses per 1000 patient days (-222.13; P<0.001) and days of therapy per 1000 patient days (-452.49; P<0.001) in the post-intervention period with a clear inversion of the Access to Watch ratio (from 0.7 to 1.7). Length of stay, in-hospital mortality, intensive care unit transfers, and incidence of AMR infections remained stable, while 30-day readmission decreased from 4.9 per 100 admissions to 2.8 per 100 admissions (P<0.001).
Conclusions:
The intervention was associated with a significant reduction in antimicrobial consumption and an increase in the appropriateness of prescriptions. Electronic tools can be of value in promoting adherence to guidelines and ensuring the sustainability of results.
More Related Videos
08:58Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
09:59Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance
Published on: July 21, 2023
Related Concept Videos
00:57Antibiotic Selection
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Principles of Disease Surveillance