ArticleAntibiotics (Basel, Switzerland)2026
Impact of a Multifaceted Antimicrobial Stewardship Program on Antimicrobial Use and Prescription Quality in a Pediatric Intensive Care Unit: An Interrupted Time-Series Study.
Article in Antibiotics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInappropriate antibiotic use contributes to antimicrobial resistance. Evidence regarding the impact of antimicrobial stewardship programs (ASPs) in pediatric intensive care units (PICUs) remains limited. The study aims to evaluate the impact of a multidisciplinary prospective post-prescription review and feedback (PPRF) ASP in a European PICU on antimicrobial use and prescription quality (PQ).
methodsA prospective quasi-experimental study was conducted using interrupted time-series analysis to evaluate antimicrobial use trends before (July 2018-December 2020) and after (January 2021-March 2025) the implementation of a multifaceted ASP, integrated within a hospital-wide ASP, in a tertiary 24-bed medical-surgical PICU in Barcelona, Spain. Antimicrobial use was measured as days of therapy per 100 patient-days (DOT/100 PD) and per 100 discharges (DOT/100 D) and was analyzed by WHO AWaRe group and by individual drug. PQ was evaluated by means of cross-sectional point-prevalence surveys (PPSs).
resultsDuring the study-period, median monthly activity in the PICU remained stable: 475 patient-days (IQR: 396-534) and 113 patients discharged (IQR: 102-124). Following ASP implementation, total antibiotic consumption significantly decreased, with an immediate reduction of 18.2 DOT/100 patient-days (
conclusionsImplementation of a multidisciplinary PPRF-based ASP in a tertiary PICU was associated with a sustained reduction in antibiotic exposure without compromising prescription quality or clinical safety. These data support the effectiveness of collaborative stewardship in one of the most complex pediatric healthcare settings.
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