[Development and integration of ASP assessment tools for bacteraemia and infections caused by multidrug-resistant...

Antimicrobial resistance is a major global public health challenge with particular implications in pediatrics. Antimicrobial stewardship programs (ASPs) require structured tools to assess prescribing quality, especially in complex clinical scenarios such as bloodstream infections and multidrug-resistant organism infections. The aim of this study was to design and implement a structured support program for managing these infections in a pediatric hospital, including an evaluation tool, a standard operating procedure, and its integration into the electronic health record.

The program was developed in 2025 within the ASP team of a tertiary pediatric hospital. Two evaluation tools were designed based on the AFinf methodology of the Spanish Society of Hospital Pharmacy and quality indicators reported in the literature. A standard operating procedure was developed in accordance with the PROA certification standards, and the tools were integrated into the hospital's electronic prescribing system.

Two structured evaluation tools were obtained (23 items for bloodstream infections and 21 for multidrug-resistant organisms), organized across four dimensions: patient identification, diagnostic adequacy, antimicrobial treatment adequacy, and ASP intervention. A multidisciplinary care pathway was formalized, and electronic integration was completed, enabling systematic data analysis.

The program represents a feasible strategy aligned with current ASP certification standards, with the added value of being specifically designed for the pediatric population, a setting where dedicated and validated tools remain a pressing need.