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Antimicrobial stewardship program in a pediatric intensive care unit of a tertiary care children’s hospital in Saudi Arabia – a pilot study

  • LS AlAwdah
  • D AlShahrani
  • M AlShehri
  • T AlFawaz
  • N ElSidig
  • A AlAwfi
  • K Baba
  • A AlAqeel
  • A AlSharif
  • I AlHarfi
  • S Amjad
  • A AlDarwish
  • S Rasheed
Open Access
Poster presentation
  • 310 Downloads

Keywords

Vancomycin Pediatric Intensive Care Unit Antimicrobial Resistance Interventional Study Educational Session 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Antimicrobial resistance is a serious global threat that needs urgent attention. Antimicrobial stewardship (AS) programs were proven to be effective in reducing antibiotic days in adults. Pediatric-specific data about the effectiveness of implementation of such programs are limited especially in the Middle East.

Objectives

Our primary objective was to identify the top three antibiotics and measure their specific days of therapy (DOT) per 1000 pediatric intensive care unit (PICU) days per quarter before and after the AS intervention.

Methods

We conducted a pilot prospective quality-improvement interventional study in a 20-bed PICU in a specialized tertiary care children’s hospital in Riyadh, Saudi Arabia from April to December 2014. Data about antimicrobial indication and utilization were gathered from study-designed forms. An AS member from pediatric infectious disease team rounded three times per week on all patients in PICU and provided antibiotic-related recommendations based on available bedside information and ensured adherence to antimicrobial restriction policy. Intervention also included educational sessions to physicians and nurses about proper use of antibiotics.

Results

During the study period, 648 children out of 898 PICU admissions (72.2%) were utilizing antimicrobials. Vancomycin, Pipracillin/Tazobactam and Meropenum represented approximately 60% of the 36 antimicrobials used. Per quarter, antibiotic-specific DOT dropped from 348.5 to 320.5 (8.0%, p-value <0.001) for Vancomycin, 356.2 to 294.7 (17.3%, p-value <0.001) for Pipracillin/Tazobactam, 162.0 to 111.1 (31.4%, p-value <0.001) for Meropenum.

Conclusion

Education and bedside real-time AS recommendations significantly dropped the use of Meropenum, Pipracillin/Tazobactam and Vancomycin. Moreover, AS program proved to be effective and promising in reducing antibiotic days in PICU.

Disclosure of interest

None declared.

Copyright information

© AlAwdah et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • LS AlAwdah
    • 1
  • D AlShahrani
    • 1
  • M AlShehri
    • 1
  • T AlFawaz
    • 1
  • N ElSidig
    • 2
  • A AlAwfi
    • 2
  • K Baba
    • 3
  • A AlAqeel
    • 3
  • A AlSharif
    • 4
  • I AlHarfi
    • 4
  • S Amjad
    • 4
  • A AlDarwish
    • 5
  • S Rasheed
    • 6
  1. 1.Pediatric Infectious DiseasesChildren’s Specialized HospitalKing Fahad Medical CitySaudi Arabia
  2. 2.Pediatric Infectious DiseasesChildren’s Specialized HospitalKing Fahad Medical CitySaudi Arabia
  3. 3.Microbiology LaboratoryKing Fahad Medical CitySaudi Arabia
  4. 4.Pediatric Intensive Care UnitChildren’s Specialized HospitalKing Fahad Medical CitySaudi Arabia
  5. 5.Clinical Pharmacy DepartmentKing Fahad Medical CitySaudi Arabia
  6. 6.Quality Management DepartmentKing Fahad Medical CitySaudi Arabia

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