Implementing an antibiotic stewardship program to reduce the duration of antibiotics in community-acquired pneumonia: Experience in a French pediatric hospital

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2025-05-01 DOI:10.1016/j.arcped.2025.02.002

Lise Martin Perceval , Matthieu Wargny , Myriam Benhamida , Morgane Dumortier , Christèle Gras-Le Guen , Dominique Navas , Elise Launay

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引用次数: 0

Abstract

Objective

This work used a before–after study to evaluate the impact of a multifaceted stewardship intervention on the recommended duration of antibiotic treatment (5 vs 10 days) for non-severe community-acquired pneumonia (CAP) in pediatrics.

Methods

Children under age 15 years and 3 months who consulted for CAP in the emergency care unit of Nantes University Hospital from November 2019 to January 2020 and from December 2020 to April 2021 were included. Before the second period, the updated protocol was presented at a local meeting, sent by e-mail, and added to the internal network; physicians’ knowledge was tested through clinical situations and answers to the questionnaire as well as pocket cards were distributed. The main outcome was the absolute and relative difference in prescription adequacy according to the recommended duration of antibiotic therapy (5 days) before and after the intervention.

Results

We included 134 children: 71 and 63 before and after the intervention respectively. The proportion of adequate duration of antibiotic therapy prescribed was increased: 27 (38.0 %) children in the “before” group versus 50 (79.4 %) in the “after” group (p < 0.0001). The prescription adequacy ratio (after/before) was 2.09 (95 %CI, 1.51–2.88). The mean treatment duration was significantly higher in the “before” than “after” group: 7.3 versus 5.7 days (p < 0.0001). A total of 155 days of treatment per 100 treated children was avoided. The proportion of correctly prescribed dosages was higher in the “after” than the “before” group: + 18 % (p = 0.03). The proportion of nasopharyngeal PCR tests performed was significantly higher after than before the intervention (p < 0.0001). Chest X-rays were performed in almost all children in both groups.

Conclusion

This multifaceted stewardship intervention demonstrated clinically and statistically significant results concerning the prescribed antibiotic therapy duration at individual and population levels and could be extended to other care centers and other situations.

查看原文本刊更多论文

实施抗生素管理计划以减少社区获得性肺炎的抗生素持续时间：法国儿科医院的经验。

目标：本研究采用前后对比的方法，评估多方面监管干预对儿科非重症社区获得性肺炎（CAP）推荐抗生素治疗时间（5 天 vs 10 天）的影响：方法：纳入2019年11月至2020年1月和2020年12月至2021年4月期间因CAP在南特大学医院急诊科就诊的15岁零3个月以下儿童。在第二阶段之前，在当地会议上介绍了更新后的方案，通过电子邮件发送，并将其添加到内部网络中；通过临床情况和问卷答案测试医生的知识，并分发口袋卡片。主要结果是干预前后根据建议的抗生素治疗时间（5 天）处方充分性的绝对和相对差异：我们共纳入了 134 名儿童：干预前后分别为 71 名和 63 名。处方抗生素疗程充足的比例有所上升："干预前 "组为 27（38.0%）名儿童，而 "干预后 "组为 50（79.4%）名儿童（p < 0.0001）。处方充足率（治疗后/治疗前）为 2.09（95 %CI，1.51-2.88）。治疗前 "组的平均治疗时间明显高于 "治疗后 "组：7.3 天对 5.7 天（P < 0.0001）。每 100 名接受治疗的儿童共避免了 155 天的治疗。治疗后 "组正确处方剂量的比例高于 "治疗前 "组：+ 18 % (p = 0.03).干预后进行鼻咽 PCR 检测的比例明显高于干预前（p < 0.0001）。两组中几乎所有儿童都进行了胸部 X 光检查：这一多方面的管理干预措施在个人和群体层面的抗生素处方疗程方面取得了显著的临床和统计学效果，可推广到其他医疗中心和其他情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.