Skip to main content Accessibility help
×
Home

Prevalence and Characteristics of Antimicrobial Stewardship Programs at Freestanding Children's Hospitals in the United States

  • Jason G. Newland (a1), Jeffrey S. Gerber (a2), Scott J. Weissman (a3) (a4), Samir S. Shah (a5) (a6) (a7), Chelsea Turgeon (a1), Erin B. Hedican (a1), Cary Thurm (a8), Matt Hall (a8), Joshua Courter (a7), Thomas V. Brogan (a4) (a9), Holly Maples (a10), Brian R. Lee (a1) and Adam L. Hersh (a11)...

Abstract

Background and Objective.

Antimicrobial stewardship programs (ASPs) are a mechanism to ensure the appropriate use of antimicrobials. The extent to which ASPs are formally implemented in freestanding children's hospitals is unknown. The objective of this study was to determine the prevalence and characteristics of ASPs in freestanding children's hospitals.

Methods.

We conducted an electronic survey of 42 freestanding children's hospitals that are members of the Children's Hospital Association to determine the presence and characteristics of their ASPs. For hospitals without an ASP, we determined whether stewardship strategies were in place and whether there were barriers to implementing a formal ASP.

Results.

We received responses from 38 (91%) of 42. Among responding institutions, 16 (38%) had a formal ASP, and 15 (36%) were in the process of implementing a program. Most ASPs (13 [81%] of 16) were started after 2007. The median number of full-time equivalents dedicated to ASPs was 0.63 (range, 0.1–1.8). The most common antimicrobials monitored by ASPs were linezolid, vancomycin, and carbapenems. Many hospitals without a formal ASP were performing stewardship activities, including elements of prospective audit and feedback (9 [41%] of 22), formulary restriction (9 [41%] of 22), and use of clinical guidelines (17 [77%] of 22). Antimicrobial outcomes were more likely to be monitored by hospitals with ASPs (100% vs 68%; P = .01), although only 1 program provided support for a data analyst.

Conclusions.

Most freestanding children's hospitals have implemented or are developing an ASP. These programs differ in structure and function, and more data are needed to identify program characteristics that have the greatest impact.

Copyright

Corresponding author

Children's Mercy Hospital and Clinics Kansas City, MO, 64108 (jnewlandl@cmh.edu)

References

Hide All
1. Dellit, TH, Owens, RC, McGowan, JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44: 159177.
2. Bartlett, JG. A call to arms: the imperative for antimicrobial stewardship. Clin Infect Dis 2011;53(suppl 1):S4S7.
3. Hersh, AL, Beekmann, SE, Polgreen, PM, Zaoutis, TE, Newland, JG. Antimicrobial stewardship programs in pediatrics. Infect Control Hosp Epidemiol 2009;30:12111217.
4. Agwu, AL, Lee, CK, Jain, SK, et al. A world wide web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center. Clin Infect Dis 2008;47:747753.
5. Di Pentima, MC, Chan, S, Hossain, J. Benefits of a pediatric antimicrobial stewardship program at a children's hospital. Pediatrics 2011;128:10621070.
6. Newland, JG, Stach, LM, De Lurgio, SA, et al. Impact of a pro-spective-audit-with-feedback antimicrobial stewardship program at a children's hospital. J Ped Infect Dis 2012;1:179186.
7. Fisher, BT, Lindenauer, PK, Feudtner, C. In-hospital databases. In: Strom, BL, Rimmel, SE, Hennessy, S, eds. Pharmacoepidemiology. 5th ed. Oxford, UK: Wiley-Blackwell, 2012:244258.
8. Carling, P, Fung, T, Killion, A, Terrin, N, Barza, M. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol 2003; 24:699706.
9. Klevens, RM, Morrison, MA, Nadle, J, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298:17631771.
10. Perez, F, Hujer, AM, Hujer, KM, Decker, BK, Rather, PN, Bonomo, RA. Global challenge of multidrug-resistant Acinetobacter bau-mannii. Antimicrob Agents Chemother 2007;51:34713484.
11. Metjian, TA, Prasad, PA, Kogon, A, Coffin, SE, Zaoutis, TE. Evaluation of an antimicrobial stewardship program at a pediatric teaching hospital. Pediatr Infect Dis J 2008;27:106111.
12. Standiford, HC, Chan, S, Tripoli, M, Weekes, E, Forrest, GN. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7-year program. Infect Control Hosp Epidemiol 2012;33:338345.
13. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol 2012;33: 322327.
14. Gross, R, Morgan, AS, Kinky, DE, Weiner, M, Gibson, GA, Fishman, NO. Impact of a hospital-based antimicrobial management program on clinical and economic outcomes. Clin Infect Dis 2001; 33:289295.
15. Gerber, JS, Newland, JG, Coffin, SE, et al. Variability in antibiotic use at children's hospitals. Pediatrics 2010;126:10671073.
16. Herigon, JC, Hersh, AL, Gerber, JS, Zaoutis, TE, Newland, JG. Antibiotic management of Staphylococcus aureus infections in US children's hospitals, 1999-2008. Pediatrics 2010;125:el294el300.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed