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Background: The increasing use of antimicrobial agents and resistance is becoming a serious problem in pediatric patients. Hence, antimicrobial stewardship program (ASP) is implemented to lessen the consequences. Objectives: This report aimed to demonstrate the impact of ASP on antimicrobials utilization in a referral and tertiary pediatric hospital in Isfahan, Iran. Methods: We launched an ASP for inpatients in March 2018 at the Imam Hussain Hospital, which is a 186-bed pediatrics hospital. Data was collected by ASP multidisciplinary team and using hospital records during February 2017-January 2018 (pre-intervention) and February 2019-January 2020 (post-intervention) periods. Consumption data were expressed as defined daily doses (DDDs) per 100 patient-days (PD). Independent sample t-test and paired t-test were used to assess the significance of differences. The rates of antimicrobials resistance for the most common hospital pathogens were also tracked. Results: Utilization of total antimicrobials decreased meaningfully by 12.41% (from 62.11 DDDs/100 PD in February 2017-January 2018 to 54.40 DDDs/100 PD in February 2019-January 2020; P = 0.024). The results showed that the reduction in non-restricted antimicrobials was less (5.43%) than restricted antimicrobials (27.6%). Conclusions: According to our results, the use of antimicrobials, especially the broad-spectrum ones, and the health burden costs significantly decreased after implementing ASP. Thus, continuous monitoring and educational programs are recommended to reduce the negative effects of using antimicrobials.

Objective: The intensive care unit (ICU) drug therapies have a significant impact on hospital costs, and reducing these costs has become a critical concern for hospitals. In this study, the researchers tested the theory on whether changing the ordering system of medications in the pediatric ICU (PICU)1, reduces drug wastage so that the nurse can request a fraction of one vial or ampule. More precisely, the study aimed to reduce the medication cost and wastage in our pediatric center. Methods: This study was conducted in the 16-bed PICU of Imam Hossein Hospital, which is a referral tertiary care teaching pediatric hospital with 185 beds in ten wards. A fractional ordering alternative was added to the hospital information system of the PICU of the pediatric hospital. Nurses were taught by the hospital pharmacist to understand the new way of ordering the drugs. Several highly used drugs were chosen for the intervention. The data were analyzed by an independent sample t-test using SPSS software. Results: Based on the results, changing the method of requesting medications for PICU patients and the random checking of floor stocks and the expired drugs in PICU reduced the number and cost of all medications. Conclusion: Overall, the collaboration of nurses and pharmacists can lead to cost savings in hospitals.