AI Article Synopsis
- Urinary tract infections (UTIs) are the commonest bacterial infections in children, prompting the need for better local treatment guidelines due to varying pathogen resistance rates.
- The study evaluates an 8-year pediatric antimicrobial stewardship program aimed at improving antibiotic use for UTIs in a tertiary pediatric hospital, with main focus on adherence to local treatment guidelines.
- Results indicated a temporary spike in adherence to guidelines following interventions, but showed changing resistance patterns, especially increased resistance to co-amoxiclav, highlighting the need for ongoing adjustments in treatment strategies.
Article Abstract
Background: Urinary tract infections (UTIs) are the most common bacterial infections in children. The high variability in pathogen susceptibility rates leads to the lack of clear guidelines for empiric and targeted therapies. In this view, local microbiological surveillance and locally adapted stewardship interventions need to be implemented.
Objective: The study aims to describe the results of a pediatric antimicrobial stewardship program on antibiotic prescriptions for UTIs over 8 years in a pediatric general ward of a tertiary center.
Design: This quasi-experimental study was conducted between 2015 and 2022, with two different implementations, one in 2018 and one in 2021.
Methods: Demographic, clinical, microbiological, and therapeutic data were retrieved from the electronic clinical records of included patients. The primary outcomes were adherence to local guidelines for empiric therapies and the adequacy of targeted therapy. Secondary outcomes were evaluating antibiotic prescription patterns stratified by antibiotics during hospital stay and at discharge, and assessing the microbiological characteristics of UTI episodes.
Results: During the study period, 7038 patients were admitted to the pediatric acute care unit (PACU), and 264 (3.7%) were included in this study. Adherence to local guidelines was highest immediately after the interventions, and it slightly decreased thereafter. Use of cephalosporins remained high throughout the 8 years but the changing microbiological scenario observed led to changing recommendations within the study period. An increase in strains resistant to co-amoxiclav was observed in the last years. Oral second-line agent consumption remained high but was adequate considering the prevalence of resistant bacteria.
Conclusion: The variability of antimicrobial consumption reflects the changing resistance patterns for UTIs pathogens, underlying the importance of locally adapted, persevering antimicrobial stewardship interventions.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528598 | PMC |
| http://dx.doi.org/10.1177/20499361241282824 | DOI Listing |
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