title: Prevalence and characteristics of antimicrobial stewardship programs at freestanding children's hospitals in the United States.
abstract: 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.
authors: Division of Infectious Diseases, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
authors: Jason G
authors: JG
authors: Newland
authors: Jeffrey S
authors: JS
authors: Gerber
authors: Scott J
authors: SJ
authors: Weissman
authors: Samir S
authors: SS
authors: Shah
authors: Chelsea
authors: C
authors: Turgeon
authors: Erin B
authors: EB
authors: Hedican
authors: Cary
authors: C
authors: Thurm
authors: Matt
authors: M
authors: Hall
authors: Joshua
authors: J
authors: Courter
authors: Thomas V
authors: TV
authors: Brogan
authors: Holly
authors: H
authors: Maples
authors: Brian R
authors: BR
authors: Lee
authors: Adam L
authors: AL
authors: Hersh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003625:Data Collection; D017723:Drug Utilization Review / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D005246:Feedback; D006776:Hospitals, Pediatric / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D015995:Prevalence; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents