Pediatric Antibiotic Stewardship for Community-Acquired Pneumonia: A Pre–Post Intervention Study

• Published in: Clinical pediatrics 2022-11, Vol.61 (11), p.795-801
• Main Authors: Cohen, Herman Avner, Gerstein, Maya, Loewenberg Weisband, Yiska, Richenberg, Yael, Jacobson, Eyal, Cohen, Moriya, Shkalim Zemer, Vered, Machnes, Maayan Diti
• Format: Article
• Language: English
• Subjects: Amoxicillin; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial Stewardship; Azithromycin; Azithromycin - therapeutic use; Child; Children; Community-Acquired Infections - drug therapy; Humans; Pediatrics; Pneumonia; Pneumonia - drug therapy; Primary care; Statistical analysis
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/00099228221102827

We aimed to investigate the effectiveness of an antibiotic stewardship program (ASP) on antibiotic prescription in children with community-acquired pneumonia (CAP). Antibiotic purchasing data were collected for children aged 3 months to 18 years diagnosed with CAP from November 2016 to April 2017 (pre-intervention period) and from November 2017 to April 2018 (post-intervention period). The intervention was a 1-day seminar for primary care pediatricians on the diagnosis and treatment of CAP in children according to national guidelines. There was a substantial decrease in the use of azithromycin after the intervention. In younger children, there was a 42% decrease, alongside an increased use of amoxicillin (P < .001). In older children, there was a smaller, non-statistically significant decrease in the use of azithromycin (P = .45). Our data demonstrate that the implementation of an ASP was associated with a reduction in the use of broad-spectrum antibiotics and macrolides and increased guideline adherence for the safe treatment of CAP.