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Stopping antibiotics, discharging sooner worked
Hospitalized children were discharged sooner and were less likely to be readmitted when physicians followed the recommendations of an antibiotic stewardship program, researchers reported recently in Philadelphia at the IDWeek 2014 conference. The study is the first to show the benefits of drug stewardship on children’s health.
"Studies have shown stewardship programs reduce antibiotic use and decrease the risk of resistance, but this is the first to demonstrate that these programs actually reduce length of stay and readmission in children," said Jason Newland, MD, lead author of the study and medical director of patient safety and systems reliability at Children’s Mercy Hospital-Kansas City, MO.
Based on the findings of benefit to pediatric patients, Newland recommended other hospitals implement such programs and invest the resources to support them.
Over the course of the five-year study, the antibiotic stewardship program recommended that the prescribed antibiotic be discontinued or the dose or type of antibiotic be changed in 1,191 (17%) of 7,051 hospitalized children reviewed by the program. The child’s physician had the option of accepting or rejecting the recommendation.
When the program’s recommendations were followed, the length of stay was shorter, and 30-day admissions were reduced among children who did not have complex chronic care issues, such as cerebral palsy or congenital heart disease, he said.
The length of stay averaged 68 hours and there were no 30-day readmissions among children whose doctor followed the recommendation, while the length of stay averaged 82 hours and 3.5% were readmitted within 30 days among those whose doctor did not follow the recommendation.
The most common recommendation was to discontinue the antibiotic because the stewardship program determined it wasn’t necessary. Those who continued the antibiotic remained in the hospital so they could be monitored.
"Skeptics say stopping the antibiotics and sending the kids home sooner will lead to more children being readmitted, but we didn’t find that," Newland said. "What we found was that kids were being taken off unnecessary antibiotics sooner — and in a safe manner."