STRATEGIES TO OPTIMIZE ANTIBIOTIC STEWARDSHIP IN THE OUTPATIENT PEDIATRIC POPULATION: A REVIEW OF THE LITERATURE
Loading...
Date
2023-05-15
Authors
Narrandes, Zandhirsingh
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction: About one-third of all antimicrobial prescriptions are clinically unnecessary and
potentially harmful in the outpatient pediatric setting, which is an area that commonly features
physician assistants prescribe medications. Behavioural factors were found to influence
prescription rates.
Purpose of Review: The purpose of this literature review is to present a comprehensive overview
of the best available evidence regarding the effectiveness of strategies to optimize prescribing
behaviours in outpatient pediatric settings.
Methods: 23 articles pertained to five individual stewardship strategies and bundled
interventions. Search terms were created from four main categories. Databases were searched for
articles by title and abstract for highlighting pediatrics/adolescents, outpatient prescription rates,
and effectiveness of antibiotic stewardship strategies. 39 articles were found and 19 articles were
chosen for review. Older studies (pre-2017) and those with adult samples were included if recent
literature on a strategy was scarce and/or datasets were large.
Discussion: Bundled and non-bundled approaches were associated with better first-line antibiotic
prescribing, reduced broad-spectrum antibiotic prescribing, reduced prescribed antibiotic
durations, increased delayed antibiotic prescriptions, and sustained effects in studies with
postintervention periods. However, multiple studies did not utilize a pediatric sample and may
limit its generalizability.
Conclusion: By engaging in more than one behavioural strategy to combat unnecessary
antimicrobial prescriptions, physician assistants in outpatient pediatric settings will be better able
to adhere to the judicious use of antimicrobial prescriptions. More research should be undertaken
that is specific to a pediatric population, within the Canadian context, and involving physician
assistants employed in the community.