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Antimicrobial Stewardship Programs in Pediatrics

Published online by Cambridge University Press:  02 January 2015

Adam L. Hersh ,
Susan E. Beekmann ,
Philip M. Polgreen ,
Theoklis E. Zaoutis  and
Jason G. Newland
Adam L. Hersh*
Affiliation:
University of California, San Francisco
Susan E. Beekmann
Affiliation:
University of Iowa Carver College of Medicine, Iowa City
Philip M. Polgreen
Affiliation:
University of Iowa Carver College of Medicine, Iowa City
Theoklis E. Zaoutis
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia
Jason G. Newland
Affiliation:
Children's Mercy Hospitals and Clinics, Kansas City, Missouri
*
3333 California St, Ste 265, Box 0936, San Francisco, CA 94118 ([email protected])
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Abstract

Objective.

To describe the prevalence, characteristics, and barriers to implementation of antimicrobial stewardship programs (ASPs) in pediatrics.

Design and Participants.

In December 2008, we surveyed the pediatric members of the Emerging Infections Network, a network of infectious diseases consultants located throughout North America. Participants responded regarding whether their hospital had or planned to develop an ASP, its characteristics, barriers to improvement or implementation, and perceptions about antimicrobial resistance.

Results.

Of 246 pediatric infectious disease consultants surveyed, 147 (60%) responded. Forty-five respondents (33%) reported having an ASP, and 25 (18%) were planning a program. The percentage of respondents from freestanding children's hospitals who were planning ASPs was higher than the percentage of respondents from other settings who were planning ASPs (P = .04). Most existing programs were developed before 2000 and had a limited number of full-time equivalent staff, and few programs used a prospective audit-and-feedback structure. Many programs were not monitoring important end points associated with ASPs, including cost and number of antibiotic-days. The major barriers to implementation of an ASP were lack of resources, including funding, time, and personnel, noted by more than 50% of respondents. Regardless of the presence of an ASP, respondents perceived antibiotic resistance as a more significant problem nationally than at their local hospital (P < .001).

Conclusions.

The prevalence of ASPs in pediatrics is limited, and opportunities exist to improve current programs.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 12 , December 2009 , pp. 1211 - 1217
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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