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JAMA Pediatr. 2013 Sep;167(9):859-66. doi: 10.1001/jamapediatrics.2013.2241.

Antimicrobial stewardship in pediatrics: how every pediatrician can be a steward.

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Division of Pediatric Infectious Diseases, Children's National Medical Center, Washington, DC2Department of Pediatrics, George Washington University School of Medicine, Washington, DC.


Antimicrobial stewardship (AS) programs are effective in improving clinical outcomes associated with antimicrobial therapies while improving patient safety by reducing adverse events and development of bacterial resistance. Understanding the basic principles of AS is essential to the successful development and implementation of AS strategies. Identifying and developing strategies to address barriers and challenges to AS can facilitate the establishment of financial, administrative, and organizational support, and agreement and participation by individual prescribers. Review of published outcomes of AS demonstrates the effectiveness in reducing unnecessary antimicrobial use and adverse events such as Clostridium difficile infections. We also illustrate the need for further research and expansion of AS activities to office-based practices and communities by using novel and innovative AS strategies and by influencing regional and national policies.

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