Evidence map›Paper›PMID 41148702›Full record

ArticleAntibiotics (Basel, Switzerland)2025

Establishing Priority Pediatric Antimicrobial Stewardship Interventions in the US: Findings from a Delphi Consensus Study.

Harry Obeng, Emmanuel Tetteh, Sara Malone, Lauren Walsh, Tyler Walsh, Fernando J Bula-Rudas, Ritu Banerjee, Adam W Brothers, Joshua C Herigon, Katie Namtu and 16 more

Abstract read
In one paragraph

Article in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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. Observational
  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

26 authors.

Harry ObengBrown School, Washington University in St. Louis, St. Louis, MO 63130, USA.ORCID 0009-0002-8425-5512
Emmanuel TettehSchool of Public Health, Washington University in St. Louis, St. Louis, MO 63110, USA.
Sara MaloneSchool of Public Health, Washington University in St. Louis, St. Louis, MO 63110, USA.
Lauren WalshDivision of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Tyler WalshDivision of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH 43205, USA.ORCID 0009-0002-7704-6149
Fernando J Bula-RudasDepartment of Medicine, Pediatric Infectious Diseases, Johns Hopkins All Children's Hospital, Saint Petersburg, FL 33701, USA.
Ritu BanerjeePediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN 37232, USA.ORCID 0000-0002-5910-7430
Adam W BrothersDepartment of Pharmacy, Seattle Children's Hospital, Seattle, WA 98105, USA.ORCID 0009-0003-5973-4965
Joshua C HerigonDepartment of Pediatrics, The Children's Mercy Hospital, School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.ORCID 0000-0001-9247-6759
Katie NamtuInfectious Disease Clinical Pharmacy, Johns Hopkins All Children's Hospital, Saint Petersburg, FL 33701, USA.
Scott WeissmanPediatric Infectious Diseases, Seattle Children's Hospital, Seattle, WA 98105, USA.ORCID 0000-0002-3755-4010
Daniel RiggsbeeDepartment of Pediatrics, Division of Pediatric Infectious Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0002-8716-2349
Jared OlsonPediatric Infectious Diseases, University of Utah, Salt Lake City, UT 84113, USA.
Debra Lynn PalazziPediatric Infectious Diseases, Texas Children's Hospital, Houston, TX 77030, USA.
Ann WirtzDepartment of Pharmacy, Children's Mercy Kansas City, Kansas City, MO 64108, USA.ORCID 0000-0002-7011-4826
Matthew SattlerDepartment of Pediatrics, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.ORCID 0000-0001-5333-0597
Jessica TansmoreDivision of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Brittany A RodriguezDepartment of Pharmacy, Texas Children's Hospital, Houston, TX 77030, USA.ORCID 0009-0009-8737-4227
Monica AbdelnourDepartment of Pediatrics, Division of Infectious Diseases, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
Joshua R WatsonDivision of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Alison C TribbleDepartment of Pediatrics, Division of Pediatric Infectious Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109, USA.
Jessica GillonDepartment of Pharmacy, Monroe Carell Jr Children's Hospital, Nashville, TN 37232, USA.
Mari NakamuraAntimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA.ORCID 0000-0002-8191-0027
Sarah JonesAntimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA.
Jason G NewlandDivision of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, OH 43205, USA.
Virginia R McKaySchool of Public Health, Washington University in St. Louis, St. Louis, MO 63110, USA.ORCID 0000-0002-9299-3294

Funding

AHRQ HHS 1R18HS030070-01AHRQ HHS R01 HS026742AHRQ HHS R01HS026742
6 · The paper itself

Abstract

BACKGROUND/

objectivesAntimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

methodA four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases were recruited through an existing clinical trial. Using an iterative survey and in-person discussions, experts provided input on priority areas, which were thematically grouped and refined across rounds. Structured feedback supported real-time refinement and consensus-building.

resultsTwenty experts participated in the process, generating 25 priority items in Round 1 through open-ended responses. These were narrowed to seven key priorities through structured voting and discussion. The final items were clustered into three intersecting themes: Care Settings, Prescriptions, and Strategies. Care Settings focused on high-impact areas such as outpatient clinics and intensive care units, where misuse is common and/or care is complex. The prescriptions theme prioritized shorter durations and narrow-spectrum agents. The strategy theme highlighted the need for outcome-based metrics, improved diagnostic stewardship, and routine tracking of patient outcomes to guide and assess stewardship efforts.

conclusionsThis expert consensus identified key priorities for pediatric ASPs, providing a foundation for future interventions. Findings can be used to inform policy and practice, improving the appropriate use of antimicrobials in pediatrics and combating AMR.

Indexed as

antibioticsantimicrobialsinterventionmetricsstewardship

Identifiers

PMID41148702
PMCPMC12561173

What OpenQuestion holds

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LicenceCC BY
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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.