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Updated: Jun 3, 2025

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Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory.

Javier Roberti1,2, Facundo Jorro-Barón2, Natalí Ini1,2

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Summary
This summary is machine-generated.

Implementing antimicrobial stewardship programs (ASPs) in pediatric hospitals in low-income countries is challenging. Success requires addressing staff commitment and organizational context for effective antibiotic use and combating resistance.

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Area of Science:

  • Medical Research
  • Infectious Diseases
  • Public Health

Background:

  • Overprescribing antibiotics in pediatric settings fuels multidrug-resistant organisms.
  • Antimicrobial stewardship programs (ASPs) are crucial for optimizing antibiotic use and combating resistance.
  • Implementing ASPs in low- and middle-income countries presents unique challenges.

Purpose of the Study:

  • To evaluate the implementation process of a multifaceted ASP in two pediatric hospitals in Argentina.
  • To identify barriers and facilitators to ASP implementation in a resource-limited setting.

Main Methods:

  • Qualitative study utilizing semistructured interviews with 32 healthcare providers.
  • Interviews conducted at the beginning and end of ASP implementation.
  • Guided by the normalization process theory.

Main Results:

  • Challenges included limited understanding of objectives, confusion with existing practices, and insufficient senior staff commitment.
  • Communication barriers and workload concerns hindered broader adoption, despite receptive junior staff.
  • Improvements noted in standardized antibiotic guidelines, interdisciplinary collaboration, and communication, yet organizational support and resistance persisted.

Conclusions:

  • Organizational context and staff commitment are critical for successful ASP implementation.
  • Tailored strategies are essential to overcome challenges specific to low- and middle-income countries.
  • Effective ASP implementation is key to optimizing antibiotic use and combating antimicrobial resistance in pediatric populations.