Evidence map›Paper›PMID 39507942›Full record

ArticleJAC-antimicrobial resistance2024

Impact of a multifaceted antibiotic stewardship programme in a paediatric acute care unit over 8 years.

Giulia Brigadoi, Emelyne Gres, Elisa Barbieri, Cecilia Liberati, Sara Rossin, Lorenzo Chiusaroli, Giulia Camilla Demarin, Francesca Tesser, Linda Maestri, Francesca Tirelli and 6 more

Abstract read
In one paragraph

Article in JAC-antimicrobial resistance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Giulia BrigadoiDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.ORCID https://orcid.org/0009-0004-0600-7745
Emelyne GresCERPOP, UMR 1295, Inserm, University of Toulouse 3, Toulouse, France.
Elisa BarbieriDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.ORCID https://orcid.org/0000-0003-0850-8784
Cecilia LiberatiDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.ORCID https://orcid.org/0000-0002-0821-5757
Sara RossinPediatric Emergency Department, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Lorenzo ChiusaroliDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.ORCID https://orcid.org/0009-0001-9633-873X
Giulia Camilla DemarinDepartment for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Francesca TesserDepartment for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Linda MaestriDepartment for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Francesca TirelliRheumatology Unit, Department of Woman's and Child's Health, University of Padova, Via Giustiani 3, 35128 Padua, Italy.
Elena CarraraDivision of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona 37134, Italy.ORCID https://orcid.org/0000-0003-1004-515X
Evelina TacconelliDivision of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona 37134, Italy.
Silvia BressanPediatric Emergency Department, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Carlo GiaquintoDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Liviana Da DaltPediatric Emergency Department, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.
Daniele DonàDivision of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antibiotics are the most prescribed drugs for children worldwide, but overuse and misuse have led to an increase in antibiotic resistance. Antimicrobial stewardship programmes (ASPs) have proven feasible in reducing inappropriate antimicrobial use. The study aimed at evaluating the impact and sustainability of an ASP with multiple interventions over 8 years. Methods: This quasi-experimental study was conducted between 2014 and 2022 in the paediatric acute care unit of Padua University Hospital. Demographic and clinical data were retrieved from the electronic clinical records. Daily prescriptions were collected and analysed based on the AWaRe classification and using days of therapy (DOT) out of 1000 patient days (DOT/1000PDs). The primary outcome was to assess the change in overall antibiotic consumption and of access and watch antibiotics, stratifying patients with and without comorbidities. Trends in antibiotic consumption (DOTs/1000PD) were assessed using joinpoint regression analysis. Findings: A total of 3118 children were included. Total antibiotic consumption remained stable and low in patients without comorbidities, ∼300 DOT/1000PDs, whereas a statistically significant constant reduction was observed in children with comorbidities, from almost 500 DOT/1000PPDs to <400 DOT/1000PDs. Access consumption increased in both groups of patients, whereas watch consumption constantly decreased, although statistically significant only in children with comorbidities. Interpretation: Implementing a multistep ASP has proven feasible and sustainable in improving antibiotic prescriptions for previously healthy and fragile children. All the implemented interventions were low cost, and with efficient use of resources, ensuring an ASP that was effective, practical, and easily replicable and implementable in various healthcare settings.

Identifiers

PMID39507942
PMCPMC11538966

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.