ArticleChildren (Basel, Switzerland)2022
Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain-What Have We Learned?
Article in Children (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Impact of a Multifaceted Antimicrobial Stewardship Program on Antimicrobial Use and Prescription Quality in a Pediatric Intensive Care Unit: An Interrupted Time-Series Study.Antibiotics (Basel, Switzerland) · 2026Article
- Impact of an Antimicrobial Stewardship program on mortality and consumption of antibiotics in the intensive care units of a pediatric referral hospital in Peru.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019).Antibiotics (Basel, Switzerland) · 2023Article
- Device Exposure and Patient Risk Factors' Impact on the Healthcare-Associated Infection Rates in PICUs.Children (Basel, Switzerland) · 2022Article
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Authors and funding
16 authors.
Funding
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Abstract
Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over a 3-month period each year (1 April−30 June) from 2014−2019. To make comparisons and evaluate the influence of AMS programs on antibiotic use in PICUs, the analysis was divided into two periods: 2014−2016 and 2017−2019 (once 84% of the units had incorporated an AMS program). A total of 11,260 pediatric patients were included. Total antibiotic prescriptions numbered 15,448 and, overall, 8354 patients (74.2%) received at least one antibiotic. Comparing the two periods, an increase was detected in the number of days without antibiotics in patients who received them divided by the number of days in PICUs, for community-acquired infections (p < 0.001) and healthcare-associated infections (HAIs) acquired in PICUs (p < 0.001). Antibiotics were empirical in 7720 infections (85.6%), with an increase in appropriate antibiotic indications during the second period (p < 0.001). The main indication for antibiotic adjustment was de-escalation, increasing in the second period (p = 0.045). Despite the high rate of antibiotic use in PICUs, our results showed a significant increase in appropriate antibiotic use and adjustment following the implementation of AMS programs.
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