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Role of Antimicrobial Stewardship

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Abstract

Frequent and often inappropriate prescribing and usage of antimicrobials in pediatrics has resulted in a significant increase in multidrug-resistant bacterial infections in the pediatric population. With dwindling antimicrobials in the pipeline and a rise in resistance, it is imperative to optimize the use of available antimicrobials. Antimicrobial stewardship is a coordinated effort to optimize antimicrobial choice, dose, route, and duration of therapy. The components of a successful antimicrobial stewardship program include leadership commitment, accountability, drug expertise, action, tracking/reporting, and education. Prospective audit with feedback and preauthorization are two strategies that have been shown to be effective to improve antimicrobial use. Additionally, development of clinical best practice guidelines, coupled with pharmacy-led antimicrobial stewardship initiatives, augments appropriate antimicrobial choices. Trending antimicrobial stewardship outcomes such as days of therapy, defined daily doses, and other outcome measures should be assessed on a regular basis to determine appropriate antimicrobial usage. Antimicrobial stewardship programs should aim to provide routine education via didactic lectures, flyers, or newsletters to targeted audiences on a regular basis to support appropriate prescribing.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and The Children’s Hospital of San Antonio, San Antonio, TX, USA

    Luis A. Castagnini

  2. Pharmacy, The Children’s Hospital of San Antonio, San Antonio, TX, USA

    Sarah Kubes

Authors
  1. Sarah Kubes
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  2. Luis A. Castagnini
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Corresponding author

Correspondence to Luis A. Castagnini .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    J. Chase McNeil

  2. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Judith R. Campbell

  3. Department of Pediatrics, Baylor College of Medicine and The Children’s Hospital of San Antonio, San Antonio, TX, USA

    Jonathan D. Crews

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Kubes, S., Castagnini, L.A. (2019). Role of Antimicrobial Stewardship. In: McNeil, J., Campbell, J., Crews, J. (eds) Healthcare-Associated Infections in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-98122-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-98122-2_3

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