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Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital.
Front Pediatr 2019; 7:478FP

Abstract

Introduction: The accelerating threat of multidrug-resistant bacteria (MRB) forces health care providers to use antibiotics more rationally. Antibiotic stewardship programs (ASP) are a proven and safe way to achieve that goal. They have been comprehensively studied in adults but data from secondary care pediatric hospitals are lacking. Material and

Methods:

In our study an ASP with standard operating procedures (SOPs), audits, a weekly ward round with experts in pediatric infectious diseases and an antibiotic pocket-card for selected infectious diseases was established in July 2017 in a Munich municipal secondary care children's hospital. All antibiotic prescriptions on general pediatric wards were reviewed each in the first quarter of 2017 and 2018. The primary outcome was adherence to treatment guidelines. Secondary outcomes were substance consumption, duration of therapy and death.

Results:

After the ASP was implemented guideline adherence increased significantly from 33 to 63%. The consumption of cephalosporins decreased significantly (-60%), whereas aminopenicillin use increased accordingly (+120%). Neither in the pre- nor in the post-intervention group deaths occurred. Discussion: Data on ASP in pediatric secondary care hospitals are scarce. Most previous studies have been performed at tertiary care/university children's hospitals. We demonstrate a significant improvement in guideline adherence regarding antibiotic treatments after the implementation of an ASP. Cephalosporin consumption decreased which might be relevant for the selection of MRB (e.g., vancomycin-resistant enterococci). Results are limited by the single-center design and the short observation period. The study encourages the implementation of ASPs in secondary care children's hospitals.

Authors+Show Affiliations

Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany.Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany.Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany.Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany.Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany. German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.Klinik für Kinder- und Jugendmedizin, München Klinik Schwabing und Harlaching; and Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany. Children's Hospital, University of Tübingen, Tübingen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31799227

Citation

Metz, Jakob, et al. "Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital." Frontiers in Pediatrics, vol. 7, 2019, p. 478.
Metz J, Oehler P, Burggraf M, et al. Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital. Front Pediatr. 2019;7:478.
Metz, J., Oehler, P., Burggraf, M., Burdach, S., Behrends, U., & Rieber, N. (2019). Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital. Frontiers in Pediatrics, 7, p. 478. doi:10.3389/fped.2019.00478.
Metz J, et al. Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital. Front Pediatr. 2019;7:478. PubMed PMID: 31799227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement of Guideline Adherence After the Implementation of an Antibiotic Stewardship Program in a Secondary Care Pediatric Hospital. AU - Metz,Jakob, AU - Oehler,Philipp, AU - Burggraf,Manuela, AU - Burdach,Stefan, AU - Behrends,Uta, AU - Rieber,Nikolaus, Y1 - 2019/11/13/ PY - 2019/08/12/received PY - 2019/10/30/accepted PY - 2019/12/5/entrez PY - 2019/12/5/pubmed PY - 2019/12/5/medline KW - ASP KW - antibiotic stewardship KW - antimicrobial stewardship KW - multidrug-resistance KW - pediatric hospital KW - pediatrics KW - secondary care SP - 478 EP - 478 JF - Frontiers in pediatrics JO - Front Pediatr VL - 7 N2 - Introduction: The accelerating threat of multidrug-resistant bacteria (MRB) forces health care providers to use antibiotics more rationally. Antibiotic stewardship programs (ASP) are a proven and safe way to achieve that goal. They have been comprehensively studied in adults but data from secondary care pediatric hospitals are lacking. Material and Methods: In our study an ASP with standard operating procedures (SOPs), audits, a weekly ward round with experts in pediatric infectious diseases and an antibiotic pocket-card for selected infectious diseases was established in July 2017 in a Munich municipal secondary care children's hospital. All antibiotic prescriptions on general pediatric wards were reviewed each in the first quarter of 2017 and 2018. The primary outcome was adherence to treatment guidelines. Secondary outcomes were substance consumption, duration of therapy and death. Results: After the ASP was implemented guideline adherence increased significantly from 33 to 63%. The consumption of cephalosporins decreased significantly (-60%), whereas aminopenicillin use increased accordingly (+120%). Neither in the pre- nor in the post-intervention group deaths occurred. Discussion: Data on ASP in pediatric secondary care hospitals are scarce. Most previous studies have been performed at tertiary care/university children's hospitals. We demonstrate a significant improvement in guideline adherence regarding antibiotic treatments after the implementation of an ASP. Cephalosporin consumption decreased which might be relevant for the selection of MRB (e.g., vancomycin-resistant enterococci). Results are limited by the single-center design and the short observation period. The study encourages the implementation of ASPs in secondary care children's hospitals. SN - 2296-2360 UR - https://www.unboundmedicine.com/medline/citation/31799227/Improvement_of_Guideline_Adherence_After_the_Implementation_of_an_Antibiotic_Stewardship_Program_in_a_Secondary_Care_Pediatric_Hospital L2 - https://doi.org/10.3389/fped.2019.00478 DB - PRIME DP - Unbound Medicine ER -