Clinical Pathways Can Improve the Choice of Antibiotic and PAP Duration in Pediatric Patients
A study by Donà , et al. (2019) aimed to determine the effectiveness of an antimicrobial stewardship program based on a clinical pathway (CP) to improve appropriateness in perioperative antibiotic prophylaxis (PAP).
This pre-post quasi-experimental study was conducted in a 12-month period (six months before and six months after CP implementation) in a tertiary pediatric surgery center. All patients from 1âmonth to 15âyears of age receiving one or more surgical procedures were eligible for inclusion. PAP was defined appropriate according to clinical practice guidelines.
Seven-hundred sixty-six children were included in the study, 394 in pre-intervention and 372 in post-intervention. After CP implementation, there was an increase in appropriate PAP administration, as well as in the selection of the appropriate antibiotic for prophylaxis, both for monotherapy (pâ=â0.02) and combination therapy (pâ=â0.004). Even the duration of prophylaxis decreased during the post-intervention period, with an increase of correct PAP discontinuation from 45.1 to 66.7% (pâ<â0.001). Despite the greater use of narrow-spectrum antibiotic for fewer days, there was no increase in treatment failures (10/394 (2.5%) pre vs 7/372 (1.9%) post, pâ=â0.54).
The researchers concluded that CPs can be a useful tool to improve the choice of antibiotic and the duration of PAP in pediatric patients.
Reference: Donà D, et al. Effects of an antimicrobial stewardship intervention on perioperative antibiotic prophylaxis in pediatrics. Antimicrobial Resistance & Infection Control.2019;8:13
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