Inappropriate Use of Antibiotics in Pediatrics

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 633

Special Issue Editor


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Guest Editor
Department of Health Services and Outcomes Research, Children’s Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA
Interests: antimicrobial stewardship; health disparities; epidemiology; clinical decision making; diagnostic microbiology

Special Issue Information

Dear Colleagues,

This Special Issue will collect all knowledge related to inappropriate prescriptions of antibiotics in pediatric patients. Prior research has shown that an estimated 20–50% of prescribed antibiotics are considered unnecessary. This pattern has been demonstrated in both inpatient and outpatient scenarios, though research has not focused solely on the pediatric population. Tribble and colleagues examined over 17,000 antibiotic orders among admitted pediatric patients from 32 hospitals and classified 21% of these orders as suboptimal/inappropriate [Clin Infect Dis; doi:10.1093/cid/ciaa036]. Nearly half of these suboptimal/inappropriate orders in that study would not have been routinely identified by antimicrobial stewardship programs. Diggs and colleagues conducted a similar study and reported that of the 13,000 antibiotic orders, 13.8% were considered inappropriate [Infect Control Hosp Epidemiol; doi:10.1017/ice.2023.56]. One key finding from this study was the substantial variation in inappropriate prescriptions by clinical service, including the highest levels of inappropriateness in PICU (19.4%) and surgical sub-specialty (22.5%) pediatric patients. A recent analysis of U.S. MarketScan commercial inpatient/outpatient pediatric claims data revealed that approximately 30% of the antibiotics used for bacterial infections and up to 70% of viral infections were considered inappropriate [JAMA Netw Open; doi:10/1001/jamanetworkopen.2022.14153]. More research is needed to not only fully understand the overall prevalence of inappropriate use, but also elucidate reasons for this inappropriateness, identify key drivers, and identify intervention opportunities. 

Dr. Brian R. Lee
Guest Editor

Manuscript Submission Information

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Keywords

  • antimicrobial stewardship
  • inappropriate antibiotic prescription
  • antimicrobial resistance
  • pediatrics

Published Papers (1 paper)

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Research

12 pages, 1466 KiB  
Article
Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care
by Santiago Alfayate-Miguélez, Gema Martín-Ayala, Casimiro Jiménez-Guillén, Manuel Alcaraz-Quiñonero, Rafael Herrero Delicado and José Arnau-Sánchez
Antibiotics 2024, 13(7), 572; https://doi.org/10.3390/antibiotics13070572 - 21 Jun 2024
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Abstract
A multifaceted, participatory, open program based on a qualitative and quantitative approach was developed in the Region of Murcia (Spain) aimed to reduce antibiotic use in children under 3 years of age diagnosed with upper respiratory tract infections (acute otitis media, pharyngitis, and [...] Read more.
A multifaceted, participatory, open program based on a qualitative and quantitative approach was developed in the Region of Murcia (Spain) aimed to reduce antibiotic use in children under 3 years of age diagnosed with upper respiratory tract infections (acute otitis media, pharyngitis, and common cold). Antibiotic consumption was measured using the defined daily dose per 1000 inhabitants per day (DHD). Pre-intervention data showed a prevalence of antibiotic prescriptions in the primary care setting of 45.7% and a DHD of 19.05. In 2019, after the first year of implementation of the program, antibiotic consumption was 10.25 DHD with an overall decrease of 48% as compared with 2015. Although antibiotic consumption decreased in all health areas, there was a large variability in the magnitude of decreases across health areas (e.g., 12.97 vs. 4.77 DHD). The intervention program was effective in reducing the use of antibiotics in children under 3 years of age with common upper respiratory diseases, but reductions in antibiotic consumption were not consistent among all health areas involved. Full article
(This article belongs to the Special Issue Inappropriate Use of Antibiotics in Pediatrics)
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