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Prevalence and Characteristics of Antimicrobial Stewardship Programs at Freestanding Children's Hospitals in the United States

Published online by Cambridge University Press:  10 May 2016

Jason G. Newland ,
Jeffrey S. Gerber ,
Scott J. Weissman ,
Samir S. Shah ,
Chelsea Turgeon ,
Erin B. Hedican ,
Cary Thurm ,
Matt Hall ,
Joshua Courter  and
Thomas V. Brogan
...Show all authors
Jason G. Newland*
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
Jeffrey S. Gerber
Affiliation:
Division of Infectious Diseases and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Scott J. Weissman
Affiliation:
Division of Infectious Diseases, Seattle Children's Hospital, Seattle, Washington Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
Samir S. Shah
Affiliation:
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio University of Cincinnati College of Medicine, Cincinnati, Ohio Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Chelsea Turgeon
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
Erin B. Hedican
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
Cary Thurm
Affiliation:
Children's Hospital Association, Overland Park, Kansas
Matt Hall
Affiliation:
Children's Hospital Association, Overland Park, Kansas
Joshua Courter
Affiliation:
Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Thomas V. Brogan
Affiliation:
Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington Division of Critical Care, Seattle Children's Hospital, Seattle, Washington
Holly Maples
Affiliation:
Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Brian R. Lee
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
Adam L. Hersh
Affiliation:
Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City, Utah
*
Children's Mercy Hospital and Clinics Kansas City, MO, 64108 (jnewlandl@cmh.edu)
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Abstract

Background and Objective.

Antimicrobial stewardship programs (ASPs) are a mechanism to ensure the appropriate use of antimicrobials. The extent to which ASPs are formally implemented in freestanding children's hospitals is unknown. The objective of this study was to determine the prevalence and characteristics of ASPs in freestanding children's hospitals.

Methods.

We conducted an electronic survey of 42 freestanding children's hospitals that are members of the Children's Hospital Association to determine the presence and characteristics of their ASPs. For hospitals without an ASP, we determined whether stewardship strategies were in place and whether there were barriers to implementing a formal ASP.

Results.

We received responses from 38 (91%) of 42. Among responding institutions, 16 (38%) had a formal ASP, and 15 (36%) were in the process of implementing a program. Most ASPs (13 [81%] of 16) were started after 2007. The median number of full-time equivalents dedicated to ASPs was 0.63 (range, 0.1–1.8). The most common antimicrobials monitored by ASPs were linezolid, vancomycin, and carbapenems. Many hospitals without a formal ASP were performing stewardship activities, including elements of prospective audit and feedback (9 [41%] of 22), formulary restriction (9 [41%] of 22), and use of clinical guidelines (17 [77%] of 22). Antimicrobial outcomes were more likely to be monitored by hospitals with ASPs (100% vs 68%; P = .01), although only 1 program provided support for a data analyst.

Conclusions.

Most freestanding children's hospitals have implemented or are developing an ASP. These programs differ in structure and function, and more data are needed to identify program characteristics that have the greatest impact.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 3 , March 2014 , pp. 265 - 271
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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