Antimicrobial stewardship: a national priority.

1. Beatriz Larru, MD, PhD 1. The Children’s Hospital of Philadelphia, Philadelphia, PA. 1. Pranita D. Tamma, MD, MHS 1. Charlotte Bloomberg Children’s Center, The Johns Hopkins University School of Medicine, Baltimore, MD. 1. Antibiotic Resistance Threats. Atlanta, GA: US Dept of Health and Human Services, Centers for Diseases Control and Prevention; 2013. http://www.cdc.gov/drugresistance/threatreport-2013. Accessed May 30, 2014 2. 1. Hyun DY, 2. Hersh AL, 3. Namtu K, 4. et al Antimicrobial Stewardship in Pediatrics: How Every Pediatrician Can Be a Steward. Hyun DY, Hersh AL, Namtu K, et al. JAMA Pediatr. 2013;167(9):859–866 [OpenUrl][1][CrossRef][2][PubMed][3] 3. 1. Newland JG, 2. Gerber JS, 3. Weissman SJ, 4. et al Prevalence and Characteristics of Antimicrobial Stewardship Programs at Freestanding Children’s Hospitals in the United States. Newland JG, Gerber JS, Weissman SJ, et al. Infect Control Hosp Epidemiol. 2014;35(3):265–271 [OpenUrl][4][CrossRef][5][PubMed][6] 4. 1. Gerber JS, 2. Newland JG, 3. Coffin SE, 4. et al Variability in Antibiotic Use at Children’s Hospitals. Gerber JS, Newland JG, Coffin SE, et al. Pediatrics. 2010;126(6):1067–1073. [OpenUrl][7][Abstract/FREE Full Text][8] The Centers for Diseases Control and Prevention estimate that more than 2 million antibiotic-resistant infections occur annually in the United States, with at least 23,000 people dying each year as a result. The ability of microorganisms to develop resistance to antibiotics predates the discovery of antimicrobial agents and is an inevitable consequence of bacterial evolution. However, this process is accelerated with the use of antibiotics. A study of 40 children’s hospitals in the United States indicates that approximately 60% of hospitalized children receive antibiotics during their inpatient stay, with almost 50% of inpatient antibiotic use estimated to be inappropriate. The overuse and misuse of antibiotics have resulted in an unprecedented selection pressure that has made almost all disease-causing bacteria resistant to some of the antibiotics commonly used to treat them. Pharmaceutical development that previously kept us ahead of antibiotic resistance has significantly decelerated. Currently, no antibiotics are in the advanced stages of development that will have activity against some of our most highly drug-resistant gram-negative organisms, including certain types of carbapenem-resistant Enterobacteriaceae, multidrug-resistant … [1]: {openurl}?query=rft.jtitle%253DJAMA%2BPediatr%26rft.volume%253D167%26rft.spage%253D859%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjamapediatrics.2013.2241%26rft_id%253Dinfo%253Apmid%252F23857121%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jamapediatrics.2013.2241&link_type=DOI [3]: /lookup/external-ref?access_num=23857121&link_type=MED&atom=%2Fpedsinreview%2F36%2F1%2F39.atom [4]: {openurl}?query=rft.jtitle%253DInfect%2BControl%2BHosp%2BEpidemiol%26rft.volume%253D35%26rft.spage%253D265%26rft_id%253Dinfo%253Adoi%252F10.1086%252F675277%26rft_id%253Dinfo%253Apmid%252F24521592%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [5]: /lookup/external-ref?access_num=10.1086/675277&link_type=DOI [6]: /lookup/external-ref?access_num=24521592&link_type=MED&atom=%2Fpedsinreview%2F36%2F1%2F39.atom [7]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2010-1275%26rft_id%253Dinfo%253Apmid%252F21078728%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=126/6/1067&atom=%2Fpedsinreview%2F36%2F1%2F39.atom