We cannot solve our problems with the same thinking we used when we created them.
Albert Einstein
Antimicrobial resistance to common bacterial pathogens poses a substantial threat to pediatric public health.1,2 Years of inappropriate and persistent antibiotic overuse, and consequent selective pressure, has led to the evolution of resistant strains of common bacteria that infect children, such as Escherichia coli, Streptococcus pneumonia, and Staphylococcus aureus. Moreover, the overuse of antibiotics has been implicated as a contributor to childhood morbidities such as asthma and obesity. In response, antimicrobial stewardship (AMS) programs have been created in many institutions.3,4 These AMS programs use a collection of strategies, including guidelines, surveillance, education, and evaluation, to optimize antibiotic use.1-4 The establishment of AMS programs has resulted in measurable positive effects, including improved selection of appropriate antimicrobials, reduction in adverse effects from unnecessary antibiotic exposure, and even local reductions in the prevalence of resistant bacteria.2,3 Importantly, AMS programs produce substantial institutional cost savings, as high as $900 000 annually.3 Consequently, AMS programs are fully established in many children’s hospitals across the United States.4,5