Publication:

The outcome of implementing antimicrobial stewardship program for hospitalized children

Background An effective approach to improve antimicrobial use for hospitalized patients is an antimicrobial stewardship program (ASP). The present study aimed to implement ASP for inpatient children based on prospective-audit-with-feedback intervention in order to evaluate the impact on patient’s outcome, antimicrobial use, and the hospital cost.

Methods The study was conducted throughout 6 months over 275 children admitted with different infections at Main Children’s hospital in Alexandria included; group I (with ASP) and group II (standard antimicrobials as controls).

Results The study revealed that on patient’s admission, single antibiotic use was higher among the ASP group while double antimicrobial therapy was higher among the non-ASP with significant difference (p=0.001). Less percentage of patients who consumed vancomycin, meropenem amoxicillin-clavulanic and metronidazole was observed among ASP group with a significant difference of the last two drugs when compared to controls (p=<0.001, 0.011, respectively). The study reported the higher percent of improved ASP patient’s after 72 hours of admission with a significant difference to controls (73.2% versus 62.5%, p=0.038). Complications occurred more likely for the non-ASP group (odds ratio 7.374 with 95% CI 1.68-32.33). In general, there was a clear reduction of the patient antibiotic cost/day and overall cost per patient, however, it was not significant among the studied patients.

Conclusions Our local ASP model provided a high quality of care for hospitalized children and effectively reduced the antimicrobial consumption.