Effects of an antimicrobial stewardship intervention on perioperative antibiotic prophylaxis in pediatrics.

TitleEffects of an antimicrobial stewardship intervention on perioperative antibiotic prophylaxis in pediatrics.
Publication TypeJournal Article
Year of Publication2019
AuthorsDonà D, Luise D, La Pergola E, Montemezzo G, Frigo A, Lundin R, Zaoutis TE, Gamba P, Giaquinto C
JournalAntimicrob Resist Infect Control
Volume8
Pagination13
Date Published2019
ISSN2047-2994
Abstract

Purpose: This study aims to determine the effectiveness of an Antimicrobial Stewardship Program based on a Clinical Pathway (CP) to improve appropriateness in perioperative antibiotic prophylaxis (PAP).

Materials and methods: This pre-post quasi-experimental study was conducted in a 12 month period (six months before and six months after CP implementation), in a tertiary Pediatric Surgical Centre. All patients from 1 month to 15 years of age receiving one or more surgical procedures were eligible for inclusion. PAP was defined appropriate according to clinical practice guidelines.

Results: Seven hundred sixty-six children were included in the study, 394 in pre-intervention and 372 in post-intervention. After CP implementation, there was an increase in appropriate PAP administration, as well as in the selection of the appropriate antibiotic for prophylaxis, both for monotherapy (p = 0.02) and combination therapy (p = 0.004). Even the duration of prophylaxis decreased during the post-intervention period, with an increase of correct PAP discontinuation from 45.1 to 66.7% (p < 0.001). Despite the greater use of narrow-spectrum antibiotic for fewer days, there was no increase in treatment failures (10/394 (2.5%) pre vs 7/372 (1.9%) post, p = 0.54).

Conclusions: CPs can be a useful tool to improve the choice of antibiotic and the duration of PAP in pediatric patients.

DOI10.1186/s13756-019-0464-z
Alternate JournalAntimicrob Resist Infect Control
PubMed ID30675340
PubMed Central IDPMC6334390