A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback

Reports analyzing the impact of pediatric antimicrobial stewardship programs (ASP) over long periods of time are lacking. We thus report our ASP experience in a pediatric tertiary referral center over a long-term period from 2011 to 2018. Our ASP was implemented in 2011. The program was based primar...

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Autores principales:	Bindiya Bagga, Jeremy S. Stultz, Sandra Arnold, Kelley R. Lee
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	antimicrobial stewardship pediatric antimicrobial resistance antibiotics sepsis Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/abff68fa984a457186c1fa77f686d1d1
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spelling	oai:doaj.org-article:abff68fa984a457186c1fa77f686d1d12021-11-25T16:22:29ZA Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback10.3390/antibiotics101113072079-6382https://doaj.org/article/abff68fa984a457186c1fa77f686d1d12021-10-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1307https://doaj.org/toc/2079-6382Reports analyzing the impact of pediatric antimicrobial stewardship programs (ASP) over long periods of time are lacking. We thus report our ASP experience in a pediatric tertiary referral center over a long-term period from 2011 to 2018. Our ASP was implemented in 2011. The program was based primarily on guideline development with key stakeholders, engaging and educating providers, followed by prospective audit with feedback (PAF). Monitored antibiotics included meropenem, piperacillin–tazobactam, and cefepime, followed by the addition of ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, levofloxacin, linezolid, and vancomycin at various time points. Specifically, the program did not implemented the core strategy of formulary restriction with prior authorization. Process- and outcome-related ASP measures were analyzed. We saw a 32% decrease in overall antibiotic utilization, a 51% decrease in the utilization of antibiotics undergoing PAF, and a 72% reduction in the use of broad-spectrum antibiotics such as meropenem. There was a concomitant increase in organism susceptibility and a reduction in yearly drug purchasing costs of over USD 560,000 from baseline without changes in sepsis-related mortality. Our study highlights that a pediatric ASP based primarily on the principles of guideline development and PAF can improve antibiotic utilization and institutional bacterial susceptibilities without a detrimental impact on patient outcomes by changing the culture of antimicrobial utilization within the institution.Bindiya BaggaJeremy S. StultzSandra ArnoldKelley R. LeeMDPI AGarticleantimicrobial stewardshippediatricantimicrobial resistanceantibioticssepsisTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1307, p 1307 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antimicrobial stewardship pediatric antimicrobial resistance antibiotics sepsis Therapeutics. Pharmacology RM1-950
spellingShingle	antimicrobial stewardship pediatric antimicrobial resistance antibiotics sepsis Therapeutics. Pharmacology RM1-950 Bindiya Bagga Jeremy S. Stultz Sandra Arnold Kelley R. Lee A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
description	Reports analyzing the impact of pediatric antimicrobial stewardship programs (ASP) over long periods of time are lacking. We thus report our ASP experience in a pediatric tertiary referral center over a long-term period from 2011 to 2018. Our ASP was implemented in 2011. The program was based primarily on guideline development with key stakeholders, engaging and educating providers, followed by prospective audit with feedback (PAF). Monitored antibiotics included meropenem, piperacillin–tazobactam, and cefepime, followed by the addition of ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, levofloxacin, linezolid, and vancomycin at various time points. Specifically, the program did not implemented the core strategy of formulary restriction with prior authorization. Process- and outcome-related ASP measures were analyzed. We saw a 32% decrease in overall antibiotic utilization, a 51% decrease in the utilization of antibiotics undergoing PAF, and a 72% reduction in the use of broad-spectrum antibiotics such as meropenem. There was a concomitant increase in organism susceptibility and a reduction in yearly drug purchasing costs of over USD 560,000 from baseline without changes in sepsis-related mortality. Our study highlights that a pediatric ASP based primarily on the principles of guideline development and PAF can improve antibiotic utilization and institutional bacterial susceptibilities without a detrimental impact on patient outcomes by changing the culture of antimicrobial utilization within the institution.
format	article
author	Bindiya Bagga Jeremy S. Stultz Sandra Arnold Kelley R. Lee
author_facet	Bindiya Bagga Jeremy S. Stultz Sandra Arnold Kelley R. Lee
author_sort	Bindiya Bagga
title	A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
title_short	A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
title_full	A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
title_fullStr	A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
title_full_unstemmed	A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback
title_sort	culture change: impact of a pediatric antimicrobial stewardship program based on guideline implementation and prospective audit with feedback
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/abff68fa984a457186c1fa77f686d1d1
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A Culture Change: Impact of a Pediatric Antimicrobial Stewardship Program Based on Guideline Implementation and Prospective Audit with Feedback

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