Pediatric Pharmacology and Therapeutics

Statement of the Problem: Antibiotics are often associated with overuse, antibiotic resistance, medication errors and adverse events. Antimicrobial stewardship is a collaborative effort to improve the appropriate use of antibiotics by focusing on selection of the correct agent, dose, frequency, route and duration.

 

Discussion: Community Health Network established an antimicrobial stewardship committee in 2014. This committee has thefollowing goals based on expert guidelines:

 

a) De-escalation of antibiotics based on clinical factors and microbiologic data

b) Optimize antibiotic duration

c) Change from parenteral to oral antibiotic route

d) Dose optimization for effi cacy and safety

e) Avoid duplicate therapy

Th e committee utilizes the following to achieve the goals:

a) Establish evidence based guidelines for disease state diagnosis/ antibiotic use

i. Physician user input and buy in up front

ii. Provide education regarding guideline to physicians/ pharmacy/ nursing

b) Prospective auditing and physician intervention by pharmacy and peer feedback to prescribers.

c) Provider, unit, and Hospital Days of Th erapy (DOT) data for review and comparison to peers and national benchmarks

d) Antibiogram review

e) Formulary review with P&T committee

 

Conclusion & Significance: Pediatric antimicrobial stewardship is starting on the pediatric, pediatric intensive care and neonatal intensive care units. The goals and initiatives established in the adult population are a solid foundation for identifying pediatric opportunities.