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March 2016

Pediatric Antimicrobial Discharge Stewardship: An Unmet Need

Author Affiliations
  • 1Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah, Salt Lake City
  • 2Department of Pediatrics, Children's Mercy Hospitals & Clinics, University of Missouri, Kansas City
  • 3Division of Infectious Diseases, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2016;170(3):191-192. doi:10.1001/jamapediatrics.2015.3369

Antibiotic overuse is the most important contributor to antibiotic resistance, which is a mounting health and economic threat. Overuse also leads to avoidable costs and toxicities including disruption of the host microbiome, which has been linked with chronic illness.1 Therefore, reducing antibiotic overuse is a patient safety and public health priority.

One of the most effective strategies to reduce antibiotic overuse is implementation of antimicrobial stewardship programs. Hospital-based antimicrobial stewardship programs comprise infectious diseases pharmacists and physicians who develop interventions to optimize antimicrobial use. These interventions include requiring prior authorization for use of certain antimicrobials, real-time review of antimicrobial prescribing with education and feedback to prescribers, and guideline development. Antimicrobial stewardship programs are effective in reducing the overall volume of antibiotics prescribed as well as enhancing adherence to local and national guidelines.2,3 However, hospital-based antimicrobial stewardship programs primarily focus on antibiotic prescribing during hospitalization and rarely target prescribing at the time of discharge.

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