Successful antibiotic stewardship in hospitalized children in a developing nation.

Abstract Background Increasing antimicrobial resistance has become a looming threat to pediatric health and therefore health facilities are obliged to practice antimicrobial stewardship. This study was undertaken to review stewardship adherence in the Department of Pediatrics at the Central Hospital, Pretoria, South Africa. Methods Antibiotic prescriptions of children admitted to hospital were reviewed for consistency with the national essential medicines list from January 2017 to January 2019. Medical records of children were reviewed to obtain the primary diagnosis, requested laboratory investigations and antibiotic prescription practices. The management was adjudicated as consistent with policy by a score system. Results This study reveals that management was in agreement with standard guidelines in 69.3 % of cases with ranges from 33% to 77%. Since the start of the study in January 2017 to the final date in January 2019 there was a significant increase in the number of patients with respiratory tract infections who were treated correctly, increasing from 41% to 73% at study end. Conclusions This study is the first to report the success of antibiotic stewardship in children admitted to a tertiary hospital in South Africa. However, it is critical that antibiotic stewardship be continued and antibiotic prescriptions be aligned with guidelines.