Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study
<b>Background/Objectives</b>: To face antimicrobial resistance, antimicrobial stewardship programs (ASPs) have been implemented in the pediatric age, but the area of urgency remains understudied. We aimed to assess the impact of an educational program on optimizing antibiotic appropriate...
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MDPI AG
2024-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/1/46 |
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| author | Erika Silvestro Ilaria Mussinatto Antonia Versace Marco Denina Giulia Pruccoli Raffaella Marino Giulia Mazzetti Lorenzo Scaglione Federico Vigna Alessandra Macciotta Silvia Garazzino Claudia Bondone |
| author_facet | Erika Silvestro Ilaria Mussinatto Antonia Versace Marco Denina Giulia Pruccoli Raffaella Marino Giulia Mazzetti Lorenzo Scaglione Federico Vigna Alessandra Macciotta Silvia Garazzino Claudia Bondone |
| author_sort | Erika Silvestro |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: To face antimicrobial resistance, antimicrobial stewardship programs (ASPs) have been implemented in the pediatric age, but the area of urgency remains understudied. We aimed to assess the impact of an educational program on optimizing antibiotic appropriateness in a pediatric ED. <b>Methods</b>: We conducted a pre-post observational study with an audit, intervention, and feedback given to prescribers. We recorded all systemic antibiotic prescriptions for children attending our pediatric ED from January to March and from July to September 2020. The study’s team assigned a score to each prescription, regarding the appropriate molecule, dose, and duration of therapy, according to the diagnosis. From April to June 2020, we held weekly meetings focusing on different pediatric infectious diseases, with interaction between one to three ED physicians and the infectious disease (ID) specialist of the study’s team. We then distributed synthetic digital guidelines adapted to our reality to all prescribers. <b>Results</b>: Optimal antibiotic prescriptions increased after the intervention, with statistical significance (<i>p</i> < 0.001) in four main aspects (overall adequacy: 13% PRE vs. 43% POST; need of antibiotics: 53% vs. 68%; adequacy of the spectrum: 55% vs. 63%; adequacy of the chosen molecule: 54% vs. 62%). We observed an improvement in all the main infectious diseases and concerns all the ED physicians. The prescription of first-choice drugs increased in specific and common illnesses such as otitis and pharyngotonsillitis. <b>Conclusions</b>: An antimicrobial stewardship program is a relevant method for improving the appropriateness of antimicrobial use also in the complex setting of a pediatric ED. |
| format | Article |
| id | doaj-art-b1af53aa09914ad49fafb879b35c2f57 |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-b1af53aa09914ad49fafb879b35c2f572025-01-24T13:27:06ZengMDPI AGChildren2227-90672024-12-011214610.3390/children12010046Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post StudyErika Silvestro0Ilaria Mussinatto1Antonia Versace2Marco Denina3Giulia Pruccoli4Raffaella Marino5Giulia Mazzetti6Lorenzo Scaglione7Federico Vigna8Alessandra Macciotta9Silvia Garazzino10Claudia Bondone11Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyDivision of Pediatrics and Neonatology, P.O. Chivasso, ASL TO4, Corso G. Ferraris 3, 10034 Chivasso, TO, ItalyDepartment of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyDepartment of Clinical and Biological Sciences, University of Turin, 10126 Turin, TO, ItalyInfectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, ItalyDepartment of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy<b>Background/Objectives</b>: To face antimicrobial resistance, antimicrobial stewardship programs (ASPs) have been implemented in the pediatric age, but the area of urgency remains understudied. We aimed to assess the impact of an educational program on optimizing antibiotic appropriateness in a pediatric ED. <b>Methods</b>: We conducted a pre-post observational study with an audit, intervention, and feedback given to prescribers. We recorded all systemic antibiotic prescriptions for children attending our pediatric ED from January to March and from July to September 2020. The study’s team assigned a score to each prescription, regarding the appropriate molecule, dose, and duration of therapy, according to the diagnosis. From April to June 2020, we held weekly meetings focusing on different pediatric infectious diseases, with interaction between one to three ED physicians and the infectious disease (ID) specialist of the study’s team. We then distributed synthetic digital guidelines adapted to our reality to all prescribers. <b>Results</b>: Optimal antibiotic prescriptions increased after the intervention, with statistical significance (<i>p</i> < 0.001) in four main aspects (overall adequacy: 13% PRE vs. 43% POST; need of antibiotics: 53% vs. 68%; adequacy of the spectrum: 55% vs. 63%; adequacy of the chosen molecule: 54% vs. 62%). We observed an improvement in all the main infectious diseases and concerns all the ED physicians. The prescription of first-choice drugs increased in specific and common illnesses such as otitis and pharyngotonsillitis. <b>Conclusions</b>: An antimicrobial stewardship program is a relevant method for improving the appropriateness of antimicrobial use also in the complex setting of a pediatric ED.https://www.mdpi.com/2227-9067/12/1/46antimicrobial stewardshippediatric emergency departmentpediatric infectious diseases |
| spellingShingle | Erika Silvestro Ilaria Mussinatto Antonia Versace Marco Denina Giulia Pruccoli Raffaella Marino Giulia Mazzetti Lorenzo Scaglione Federico Vigna Alessandra Macciotta Silvia Garazzino Claudia Bondone Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study Children antimicrobial stewardship pediatric emergency department pediatric infectious diseases |
| title | Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study |
| title_full | Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study |
| title_fullStr | Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study |
| title_full_unstemmed | Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study |
| title_short | Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study |
| title_sort | antimicrobial stewardship in the pediatric emergency department an observational pre post study |
| topic | antimicrobial stewardship pediatric emergency department pediatric infectious diseases |
| url | https://www.mdpi.com/2227-9067/12/1/46 |
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