Related Experiment Video

Updated: Jun 30, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Comparative Effects of Antimicrobial Stewardship Interventions on Pediatric Antibiotic Prescribing: A Systematic

Abdulelah F Alshehri1, Nasser Saad Alshaiban2, Asaad H Alidarous3

  • 1College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU.

Cureus
|June 29, 2026
PubMed

Insights

Antimicrobial stewardship interventions for pediatric acute respiratory tract infections (ARTIs) show varied results. Strategies with accountability and performance feedback were most effective in reducing inappropriate antibiotic prescribing.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial stewardship
  • Public health

Background:

  • Acute respiratory tract infections (ARTIs) are a primary reason for antibiotic prescriptions in children.
  • A significant portion of this prescribing is inappropriate, contributing to antimicrobial resistance.
  • The effectiveness of different antimicrobial stewardship intervention strategies for pediatric ARTIs is not well-established.

Purpose of the Study:

  • To systematically review randomized controlled trials evaluating interventions to reduce antibiotic prescribing for pediatric ARTIs.
  • To assess the consistency of intervention effects across various mechanisms.
  • To identify effective antimicrobial stewardship strategies for outpatient pediatric settings.

Main Methods:

  • Systematic review of randomized and cluster-randomized controlled trials.
  • Searches conducted in major biomedical databases (PubMed, Embase, Cochrane Library, Google Scholar) up to January 2026.
  • Narrative synthesis due to clinical and methodological heterogeneity of included studies.

Main Results:

  • Eight randomized controlled trials were included in the review.
  • Interventions incorporating accountability and performance feedback showed consistent effects in reducing or optimizing antibiotic use.
  • Shared decision-making, communication-based, diagnostic-guided, and digital interventions had mixed or neutral effects.
  • No increase in reconsultation, hospital admission, or symptom deterioration was associated with reduced antibiotic use.

Conclusions:

  • Multicomponent antimicrobial stewardship approaches, particularly those including accountability mechanisms, are more consistently effective than single-component strategies.
  • These findings support the implementation of comprehensive antimicrobial stewardship programs in pediatric outpatient care.
  • Targeted interventions focusing on accountability can improve antibiotic prescribing for pediatric ARTIs without compromising patient safety.

Keywords:
antibiotic overuseantimicrobial stewardshipappropriate antibiotic prescribingclinical decision supportprimary medical care

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