Antimicrobial Stewardship in the Pediatric Emergency Department: An Observational Pre-Post Study
Erika Silvestro,
Ilaria Mussinatto,
Antonia Versace,
Marco Denina,
Giulia Pruccoli,
Raffaella Marino,
Giulia Mazzetti,
Lorenzo Scaglione,
Federico Vigna,
Alessandra Macciotta,
Silvia Garazzino,
Claudia Bondone
Affiliations
Erika Silvestro
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Ilaria Mussinatto
Division of Pediatrics and Neonatology, P.O. Chivasso, ASL TO4, Corso G. Ferraris 3, 10034 Chivasso, TO, Italy
Antonia Versace
Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Marco Denina
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Giulia Pruccoli
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Raffaella Marino
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Giulia Mazzetti
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Lorenzo Scaglione
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Federico Vigna
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Alessandra Macciotta
Department of Clinical and Biological Sciences, University of Turin, 10126 Turin, TO, Italy
Silvia Garazzino
Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Claudia Bondone
Department of Pediatric Emergency, Regina Margherita Children’s Hospital, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, TO, Italy
Background/Objectives: To face antimicrobial resistance, antimicrobial stewardship programs (ASPs) have been implemented in the pediatric age, but the area of urgency remains understudied. We aimed to assess the impact of an educational program on optimizing antibiotic appropriateness in a pediatric ED. Methods: We conducted a pre-post observational study with an audit, intervention, and feedback given to prescribers. We recorded all systemic antibiotic prescriptions for children attending our pediatric ED from January to March and from July to September 2020. The study’s team assigned a score to each prescription, regarding the appropriate molecule, dose, and duration of therapy, according to the diagnosis. From April to June 2020, we held weekly meetings focusing on different pediatric infectious diseases, with interaction between one to three ED physicians and the infectious disease (ID) specialist of the study’s team. We then distributed synthetic digital guidelines adapted to our reality to all prescribers. Results: Optimal antibiotic prescriptions increased after the intervention, with statistical significance (p Conclusions: An antimicrobial stewardship program is a relevant method for improving the appropriateness of antimicrobial use also in the complex setting of a pediatric ED.
