Establishing Priority Pediatric Antimicrobial Stewardship Interventions in the US: Findings from a Delphi Consensus...

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Global Health Security

Background:

• Antimicrobial resistance (AMR) poses a significant global health threat, with children facing heightened risks.
• Pediatric antimicrobial stewardship programs (ASPs) struggle with implementation due to reliance on adult guidelines and limited pediatric data.
• Children's unique drug metabolism and limited treatment options exacerbate AMR risks.

Purpose of the Study:

• To identify and prioritize critical intervention areas for pediatric ASPs.
• To develop evidence-based strategies for improving pediatric antimicrobial use.
• To address the challenges in implementing effective pediatric antimicrobial stewardship.

Main Methods:

• A four-round modified Delphi consensus process involving pediatric infectious disease and stewardship experts.
• Iterative surveys and in-person discussions to gather and refine expert input on priority areas.
• Thematic grouping and structured feedback for consensus-building on key interventions.

Main Results:

• Twenty experts identified 25 priority items, narrowed to seven key priorities.
• Priorities clustered into three themes: Care Settings (outpatient, ICU), Prescriptions (shorter duration, narrow-spectrum), and Strategies (outcome metrics, diagnostics, patient tracking).
• High-impact areas for intervention include outpatient clinics and intensive care units.

Conclusions:

• Expert consensus provides a foundation for developing targeted pediatric ASP interventions.
• Findings can inform policy and practice to optimize antimicrobial use in children.
• The study offers a strategic roadmap for combating AMR in pediatric populations.