Antimicrobial resistance is a growing crisis in healthcare. Various antimicrobial stewardship strategies have been used to control antibiotic use in efforts to reduce antibiotic resistance. We conducted a systematic review of antimicrobial stewardship programs in pediatric settings. Twenty-eight published studies met inclusion criteria. The majority (21 of 28) of studies had positive outcomes, but only 6 measured the impact of interventions on antimicrobial resistance. Prescriber education for a specific diagnosis (eg, otitis media) was the most effective intervention in the outpatient setting. Ancillary laboratory tests (eg, rapid diagnostic assays for viral pathogens) were most effective in the inpatient setting. Most studies had moderate to high risk of bias, mainly because of selection bias, inadequate preintervention data for time series analysis, and contamination between treatment groups. To date, there are a limited number of studies assessing antimicrobial stewardship in pediatric settings and these have heterogeneous study designs. Thus, it is difficult to determine the most effective interventions. Future studies should be designed to overcome the biases encountered in current publications.
Infectieziekten en Medische microbiologieKindergeneeskundeEducational gatheringsEducational literature distributionsBehandeling medicatieBelemmerende en bevorderende factor
Auteurs
Patel SJ
Larson EL
Kubin CJ
Saiman L
Link
A Multicenter Collaborative to Reduce Unnecessary Care in Inpatient Bronchiolitis
Sustained reduction in inappropriate treatment of asymptomatic bacteriuria in a long-term care facility through an educational intervention.
Systematic Review and Meta-Analysis: Reminder Systems to Reduce Catheter-Associated Urinary Tract Infections and Urinary Catheter Use in Hospitalized Patients
Effect of an educational intervention on optimizing antibiotic prescribing in long-term care facilities
Impact of a series of interventions in vancomycin prescribing on use and prevalence of vancomycin-resistant enterococci.