NEWS

Right medicine, right dose, right route, right duration:

Upcoming ACHIA Antibiotic Stewardship Quality
Improvement Collaborative

by Cason Benton, MD, FAAP

The 2021 AAP Policy Statement “Antibiotic Stewardship in Pediatrics” highlighted that antibiotic overuse contributes to antibiotic resistance, which is a threat to Public Health.1 Antibiotics are the most commonly prescribed class of medications among children, with the majority prescribed in an outpatient setting. While antibiotic therapy has saved many lives, overuse can cause harm. Antibiotic exposure can lead to antibiotic resistance, Clostridioides difficile (C. diff) infections and other drug-related adverse events.

Indeed, 71 percent of C. diff cases in children were community-associated after exposure to antibiotics prescribed for otitis media, sinus infections, and respiratory tract infections. Nearly 50 percent of emergency department visits are due to antibiotic-associated adverse drug events. Nearly three million infections and 35,000 deaths occur every year in the US due to antibiotic-resistant microbes, according to the Centers for Disease Control and Prevention. Antibiotics are frequently used in outpatient settings with a significant proportion of prescriptions considered unnecessary.
Prescriptions for antibiotics per 1,000 people in Alabama are among the highest in the country.

Antibiotic stewardship is a practice of using antibiotics only when necessary, and when necessary, committing to using the right drug, at the right dose, through the right route, and for the right duration. The American Academy of Pediatrics, in coordination with other organizations such as the Pediatric Infectious Diseases Society, endorses the use of antibiotic stewardship programs (ASPs) to reduce antibiotic overuse when improving patient outcomes. An effective ASP should include strong leadership, clinical decision support tools, clinician education on best prescribing practices, patient education on viral infections and symptomatic treatment, and antibiotic prescribing audits with feedback.

The Alabama Child Health Improvement Alliance (ACHIA) will conduct an Antibiotic Stewardship Quality Improvement Collaborative from December 2024 through August 2025. With ACHIA guidance, enrolled practices will develop an antibiotic stewardship program for their clinics and will qualify for Part IV Maintenance of Certification points for the American Board of Pediatrics certification. Shannon Ross, MD, MSPH, FAAP, Professor, UAB Pediatric Infectious Diseases, will discuss outpatient antibiotic stewardship at the Alabama Chapter-AAP Annual Meeting and Fall Pediatric Update on September 15 in Birmingham as well as serving as the collaborative content expert.

For more information, join us at the AL-AAP Annual Meeting or contact Rachel Latham at rlatham@alaap.org.

1 Gerber JS, Jackson MA, Tamma PD, et al.; AAP COMMITTEE ON INFECTIOUS DISEASES, PEDIATRIC INFECTIOUS DISEASES SOCIETY. Antibiotic Stewardship in Pediatrics. Pediatrics. 2021;147(1):e2020040295 https://doi.org/10.1542/peds.2020-040295

This article first appeared in the Second Quarter 2024 Edition of the Alabama Pediatrician Newsletter.