The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Effects of a nudge-based antimicrobial stewardship program in a pediatric primary emergency medical center
Abstract
Outpatient medical facilities tend to have high antimicrobial prescription rates and are therefore major targets for antimicrobial stewardship programs (ASPs). Pediatric primary emergency medical centers in Japan have difficulties in implementing conventional ASPs due to the low continuity of stewardship. Accordingly, there is a need to develop effective ASP models for these facilities. We conducted a single-center, quasi-experimental study to evaluate the effects of a nudge-based ASP in reducing unnecessary third-generation cephalosporin (3GC) prescriptions in a pediatric primary emergency care center (PEC). The implemented ASP utilizes monthly newsletters that report current antimicrobial use patterns and prescribing targets. We compared the monthly 3GC prescription numbers and proportions of unnecessary prescriptions before and after the ASP was implemented. The trends in 3GC prescriptions were examined using an interrupted time-series analysis. The numbers of patients before and after ASP implementation were 129,156 and 28,834, respectively. The number of unnecessary 3GC prescriptions decreased by 67.2% in the year after ASP implementation. The interrupted time-series analysis showed that the ASP was significantly associated with a reduction in 3GC prescriptions (regression coefficient - 0.58, P < 0.001).Conclusion: The nudge-based ASP was effective in reducing 3GC use in a Japanese PEC. This simple and inexpensive approach may have applications in other outpatient facilities. What is Known: • Outpatient medical facilities tend to have high antimicrobial prescription rates. Despite the development of several strategies for outpatient antimicrobial stewardship programs, these approaches have not sufficiently reduced antimicrobial use. What is New • Our nudge-based antimicrobial stewardship program using newsletters was shown to be a simple, inexpensive, and feasible method for reducing unnecessary antimicrobial use in a pediatric primary emergency care center. This may represent an effective antimicrobial stewardship strategy in Japanese outpatient facilities.
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“While the composition of the IPC and AMS teams varies across different settings, emerging studies from LMICs support multidisciplinary AMS teams in general, as well as being specific to paediatric departments.5,28,30–33”
From Rationalizing irrational prescribing—infection-related attitudes and practices across paediatric surgery specialties in a hospital in South India (2024) · cites this paper as [32]
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Cites
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Nudging Guideline-Concordant Antibiotic Prescribing
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Antimicrobial Stewardship in Outpatient Settings: A Systematic Review
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Research works printed but not linked: 1
- Tuberculosis and Infectious Diseases Control Division, Health Service Bureau, Ministry of Health Labour and Welfare. Manual of antimicrobial stewardship, the 2nd edition (Written in Japanese). https://www.mhlw.go.jp/content/10900000/000573655.pdf. Accessed July 28 2020.
Cited by
Surendran, S., Nampoothiri, V., Dhar, P., Holmes, A., Singh, S., & Charani, E. (2024) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlae105 · Cited by 3
Metadata
- Authors
- Shishido, A., Otake, S., Kimura, M., Tsuzuki, S., Fukuda, A., Ishida, A., Kasai, M., & Kusama, Y.
- Affiliations
- Kobe Children's Hospital (JP)
- National Center for Global Health and Medicine (JP)
- Corresponding author
- Kusama, Yoshiki
- Venue
- European Journal of Pediatrics
- Published
- 2021-02-08
- Volume
- 180
- Issue
- 6
- Pages
- 1933-1940
- ISSN
- 0340-6199 (ISSN-L)
- 1432-1076
- OpenAlex
- W3127839825
- Cited by
- 15
- References
- 30
- Citations by year
- 2026: 2 · 2024: 6 · 2023: 4 · 2022: 2 · 2021: 1
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- antimicrobial stewardship, nudge interventions, third-generation cephalosporins, unnecessary antibiotic prescribing
- MeSH terms
- Antimicrobial Stewardship, Anti-Infective Agents, Anti-Bacterial Agents, Child, Emergency Service, Hospital, Humans, Japan
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