Pediatric Antimicrobial Stewardship Programs

Abstract

The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events. This paper serves as a position statement of the Pediatric Pharmacy Advocacy Group (PPAG) who supports the implementation of antimicrobial stewardship programs for all pediatric patients. PPAG also believes that a pediatric pharmacy specialist should be included as part of that program and that services be covered by managed care organizations and government insurance entities. PPAG also recommends that states create legislation similar to that in existence in California and Missouri and that a federal Task Force for Combating Antibiotic-Resistant Bacteria be permanently established. PPAG also supports post-doctoral pharmacy training programs in antibiotic stewardship.

<p>Pediatric Antimicrobial Stewardship Programs: Current Perspectives</p>

“…4 Pediatric ASPs must have familiarity with these characteristics and recognize the necessity of antibiotic conservation for children, who could require repeated exposures to antimicrobials throughout their lifetimes. 8 Correspondence: J Michael Klatte Division of Infectious Disease, Dayton Children's Hospital, Dayton, OH 45404, USA Tel +1937-641-3329 Fax +1937-641-5931 Email KlatteM@childrensdayton.org…”

“… 4 Pediatric ASPs must have familiarity with these characteristics and recognize the necessity of antibiotic conservation for children, who could require repeated exposures to antimicrobials throughout their lifetimes. 8 …”

Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality

“…During the G7 summit in 2016, the Japanese government released a national AMR action plan to promote the judicious use of antibiotic agents to reduce AMR (Government of Japan, 2016). In the healthcare setting, an antimicrobial stewardship program (ASP) in combination with effective infection prevention and control practices is essential to combat AMR (Nichols et al, 2017). In 2016, the Infectious Diseases Society of America published new guidelines on ASPs to recommend evidence-based interventions and assessment metrics (Barlam et al, 2016).…”

European Antibiotic Awareness Day 2017: training the next generation of health care professionals in antibiotic stewardship

“…Finally, immunisation initiatives should be included in AMS programmes as a preventive strategy in both in- and outpatient paediatric settings, in order to decrease the likelihood of serious illness and to decrease AMR. Therefore, other core members of the paediatric AMS team, like the microbiologist, paediatric infectious disease specialist and clinical pharmacist, should receive training focused on the unique medical needs of the paediatric patient [ 16 , 19 ]. In addition, future paediatricians should be skilled in taking leadership roles in AMS initiatives and develop practical solutions rooted in the general principles of AMS, as it is important to further expand AMS activities from the hospital to paediatric offices and communities [ 14 ].…”