Antimicrobial stewardship reduces pediatric C. difficile infections, costs

SAN DIEGO — Rates for Clostridium difficile infections declined significantly among hospitalized pediatric patients after implementation of an antimicrobial stewardship program, according to data presented at IDWeek 2015.

“Hospitalized children were three times less likely to become sick with Clostridium difficile, a serious bacterial infection that can occur after prolonged antibiotic use, following implementation of a physician-led antibiotic stewardship program,” Jean Wiedeman, MD, PhD, of the department of pediatrics at the University of California, Davis Medical Center, told Infectious Diseases in Children. “These programs reduce the misuse of antibiotics and therefore C. diff, and also result in antibiotic cost savings. By reducing antibiotic use, the hospital saved 20 percent in antimicrobial costs after the program was implemented.”

Jean Wiedeman

The researchers analyzed data from before and after UC Davis Children’s Hospital, a 110-bed facility, instituted an antimicrobial stewardship program in 2011. A pediatric infectious disease physician and pharmacist reviewed all patients receiving antimicrobials three times weekly during the period from 2008 to 2014. The researchers determined the 16 most commonly used antibiotics, and they analyzed antimicrobial drug spending before and after program initiation.

According to data, the antimicrobial stewardship program resulted in a threefold reduction in the likelihood of pediatric patients becoming infected with C. difficile. C. difficile infections declined from 9.2 per 10,000 patient days to 2.8 per 10,000 patient days.

Wiedeman and colleagues also wrote that the stewardship program reduced antibiotic-associated costs by 20%. An annual savings of $43,572 was realized, trimming costs to $120,540.

“Pediatric stewardship programs are integral to educating physicians about appropriate antimicrobial prescribing as well as improving outcomes and safety for children in the hospital setting,” Wiedeman said. “Looking forward, it is our hope that pediatric stewardship can be addressed nationwide in medical policy.” – by David Costill

Reference:
Nakra N, et al. Poster 1468. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.

Disclosure: The researchers report no relevant financial disclosures.