Pediatric Antimicrobial Stewardship

Master
Content

Antimicrobial stewardship is a term used to describe the practice of improving the meaningful and appropriate use of antimicrobials. At Baylor College of Medicine, the pediatric antimicrobial stewardship team strives to ensure that antimicrobials prescribed in inpatient and outpatient settings are prescribed appropriately, accounting for patient clinical presentation, diagnosis, antibiotic allergies, and adherence to clinical care guidelines. Antibiotic overuse is a primary driver of antibiotic resistance, and antibiotic resistant bacteria are a continuing problem in our community. Antimicrobial stewardship – in which everyone is a critical player – is essential to ensure we continue to use the safest and most effective medications we have for years to come.

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Medical Director

People
First Name
Diana
Middle Name
Kim
Last Name
Nguyen
Honorific Title
DO
Associate Professor
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Chief of Pediatric Infectious Diseases

People
First Name
Debra
Middle Name
L
Last Name
Palazzi
Honorific Title
M.D., M.Ed.
Professor
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Assistant Director

People
First Name
Margaret
Middle Name
Graham
Last Name
Taylor
Honorific Title
M.D.
Assistant Professor
First Name
Beenish
Last Name
Rubbab
Assistant Professor
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Clinical Pharmacy Specialist

People
First Name
Brittany
Middle Name
Ann
Last Name
Rodriguez
Honorific Title
PharmD, BCIDP
Instructor
First Name
Grant
Middle Name
Thomas
Last Name
Stimes
Honorific Title
PharmD, MPA, BCPS, BCIDP
Instructor
Content

Inpatient Antimicrobial Stewardship

The pediatric antimicrobial stewardship team conducts a variety of activities at Texas Children’s Hospital campuses (Medical Center, West Campus, Woodlands, and Austin) to improve the use of antimicrobials among children, in line with the CDC Core Elements of Antimicrobial Stewardship.

Activities include:

  • Antibiotic tracking and reporting
  • Prescribing audit and feedback (aka “Handshake Rounds”)
  • Monitoring of restricted antimicrobials
  • Diagnostic stewardship
  • Management of antimicrobial drug shortages
  • Creation of surgical prophylaxis and other evidence-based guidelines

Outpatient Antimicrobial Stewardship

The antimicrobial stewardship team at Baylor College of Medicine and Texas Children’s Hospital have recently published the TCH Outpatient Antibiotic Handbook. A download will be available (anticipated, Fall 2024).

The purpose of this handbook is to provide guidance on the management of common outpatient pediatric infections, including the management of common respiratory tract infections in children with antibiotic allergies and the treatment of recurrent streptococcal pharyngitis and urinary tract infections caused by extended spectrum beta lactamase (ESBL) producing organisms.

Penicillin Allergy De-Labeling

Penicillin allergies are the most common drug allergy labels, but most children labeled as penicillin allergic tolerate penicillin following formal allergy testing. Penicillin derivatives are the treatment of choice for many common respiratory tract infections in children. Therefore, addressing unconfirmed penicillin allergy labels is a priority for antimicrobial stewardship programs.

The BCM Antimicrobial Stewardship Team has partnered with the BCM Pediatric Immunology, Allergy, and Retrovirology Division to establish a penicillin allergy stewardship program for the pediatric community in the greater Houston region. Children with unconfirmed penicillin allergies may be referred to either the pediatric infectious diseases or pediatric allergy and immunology divisions where they will be scheduled for formal penicillin allergy evaluation.

Terms

Diana Nguyen, D.O.

Item Definition

Medical Director of Antimicrobial Stewardship
Inpatient Lead

Debra

Item Term
Debra Palazzi, M.D., MEd

Item Definition

Chief of Pediatrics Infectious Diseases
Former Medical Director of Antimicrobial Stewardship