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Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success

Antibiotic stewardship programs proved to be effective in improving prescribing appropriateness. This multicenter quasi-experimental study, aimed to assesses the stewardship impact on antibiotics prescribing in different semesters from 2014 to 2019 in three pediatric emergency departments (Center A,...

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Autores principales: Barbieri, Elisa, De Luca, Maia, Minute, Marta, D’Amore, Carmen, Ciofi Degli Atti, Marta Luisa, Martelossi, Stefano, Giaquinto, Carlo, Da Dalt, Liviana, Zaoutis, Theoklis, Dona, Daniele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761799/
https://www.ncbi.nlm.nih.gov/pubmed/33291565
http://dx.doi.org/10.3390/antibiotics9120867
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author Barbieri, Elisa
De Luca, Maia
Minute, Marta
D’Amore, Carmen
Ciofi Degli Atti, Marta Luisa
Martelossi, Stefano
Giaquinto, Carlo
Da Dalt, Liviana
Zaoutis, Theoklis
Dona, Daniele
author_facet Barbieri, Elisa
De Luca, Maia
Minute, Marta
D’Amore, Carmen
Ciofi Degli Atti, Marta Luisa
Martelossi, Stefano
Giaquinto, Carlo
Da Dalt, Liviana
Zaoutis, Theoklis
Dona, Daniele
author_sort Barbieri, Elisa
collection PubMed
description Antibiotic stewardship programs proved to be effective in improving prescribing appropriateness. This multicenter quasi-experimental study, aimed to assesses the stewardship impact on antibiotics prescribing in different semesters from 2014 to 2019 in three pediatric emergency departments (Center A, B, and C) in Italy. All consecutive patients diagnosed with acute otitis media or pharyngitis were evaluated for inclusion. Two different stewardship were adopted: for Center A and B, clinical pathways were implemented and disseminated, and yearly lectures were held, for Center C, only pathways were implemented. Broad-spectrum prescription rates decreased significantly by 80% for pharyngitis and 29.5 to 55.2% for otitis after the implementation. In Center C, rates gradually increased from the year after the implementation. Amoxicillin dosage adjusted to pharyngitis recommendations in Center C (53.7 vs. 51.6 mg/kg/die; p = 0.011) and otitis recommendations in Center A increasing from 50.0 to 75.0 mg/kg/die (p < 0.001). Days of therapy in children < 24 months with otitis increased from 8.0 to 10.0 in Center A, while in older children decreased in Center A (8.0 vs. 7.0; p < 0.001) and Center B (10.0 vs. 8.0; p < 0.001). Clinical pathways combined with educational lectures is a feasible and sustainable program in reducing broad-spectrum antibiotic prescribing with stable rates over time.
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spelling pubmed-77617992020-12-26 Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success Barbieri, Elisa De Luca, Maia Minute, Marta D’Amore, Carmen Ciofi Degli Atti, Marta Luisa Martelossi, Stefano Giaquinto, Carlo Da Dalt, Liviana Zaoutis, Theoklis Dona, Daniele Antibiotics (Basel) Article Antibiotic stewardship programs proved to be effective in improving prescribing appropriateness. This multicenter quasi-experimental study, aimed to assesses the stewardship impact on antibiotics prescribing in different semesters from 2014 to 2019 in three pediatric emergency departments (Center A, B, and C) in Italy. All consecutive patients diagnosed with acute otitis media or pharyngitis were evaluated for inclusion. Two different stewardship were adopted: for Center A and B, clinical pathways were implemented and disseminated, and yearly lectures were held, for Center C, only pathways were implemented. Broad-spectrum prescription rates decreased significantly by 80% for pharyngitis and 29.5 to 55.2% for otitis after the implementation. In Center C, rates gradually increased from the year after the implementation. Amoxicillin dosage adjusted to pharyngitis recommendations in Center C (53.7 vs. 51.6 mg/kg/die; p = 0.011) and otitis recommendations in Center A increasing from 50.0 to 75.0 mg/kg/die (p < 0.001). Days of therapy in children < 24 months with otitis increased from 8.0 to 10.0 in Center A, while in older children decreased in Center A (8.0 vs. 7.0; p < 0.001) and Center B (10.0 vs. 8.0; p < 0.001). Clinical pathways combined with educational lectures is a feasible and sustainable program in reducing broad-spectrum antibiotic prescribing with stable rates over time. MDPI 2020-12-04 /pmc/articles/PMC7761799/ /pubmed/33291565 http://dx.doi.org/10.3390/antibiotics9120867 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Barbieri, Elisa
De Luca, Maia
Minute, Marta
D’Amore, Carmen
Ciofi Degli Atti, Marta Luisa
Martelossi, Stefano
Giaquinto, Carlo
Da Dalt, Liviana
Zaoutis, Theoklis
Dona, Daniele
Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title_full Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title_fullStr Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title_full_unstemmed Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title_short Impact and Sustainability of Antibiotic Stewardship in Pediatric Emergency Departments: Why Persistence Is the Key to Success
title_sort impact and sustainability of antibiotic stewardship in pediatric emergency departments: why persistence is the key to success
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761799/
https://www.ncbi.nlm.nih.gov/pubmed/33291565
http://dx.doi.org/10.3390/antibiotics9120867
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