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Antimicrobial Stewardship in Pediatrics:  How Every Pediatrician Can Be a Steward

David Y. Hyun, MD1,2; Adam L. Hersh, MD3; Katie Namtu, PharmD4; Debra L. Palazzi, MD5; Holly D. Maples, PharmD6; Jason G. Newland, MD, MEd7; Lisa Saiman, MD8
[+] Author Affiliations
1Division of Pediatric Infectious Diseases, Children’s National Medical Center, Washington, DC
2Department of Pediatrics, George Washington University School of Medicine, Washington, DC
3Division of Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City
4Department of Pharmacy, All Children’s Hospital and Johns Hopkins Medicine, Saint Petersburg, Florida
5Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston
6Division of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock
7Division of Pediatric Infectious Diseases, Children’s Mercy Hospital and Clinics, University of Missouri–Kansas City
8Department of Pediatrics, Columbia University, New York, New York
JAMA Pediatr. 2013;167(9):859-866. doi:10.1001/jamapediatrics.2013.2241.
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Antimicrobial stewardship (AS) programs are effective in improving clinical outcomes associated with antimicrobial therapies while improving patient safety by reducing adverse events and development of bacterial resistance. Understanding the basic principles of AS is essential to the successful development and implementation of AS strategies. Identifying and developing strategies to address barriers and challenges to AS can facilitate the establishment of financial, administrative, and organizational support, and agreement and participation by individual prescribers. Review of published outcomes of AS demonstrates the effectiveness in reducing unnecessary antimicrobial use and adverse events such as Clostridium difficile infections. We also illustrate the need for further research and expansion of AS activities to office-based practices and communities by using novel and innovative AS strategies and by influencing regional and national policies.

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The Antimicrobial Stewardship Team

A Venn diagram demonstrates overlapping specialist responsibility for guidance and for providing resources to hospitals, offices, and communities. MDRO indicates multidrug-resistant organism.

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