Antibiotic Prescribing Practices and Stewardship in Pediatrics

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Drugs".

Deadline for manuscript submissions: 10 November 2025 | Viewed by 591

Special Issue Editor


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Guest Editor
Division of Urgent Care, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
Interests: pediatrics; cultural competency; quality improvement; clinical practice guidelines; ambulatory care; patient engagement; utilization; health care

Special Issue Information

Dear Colleagues,

Antibiotic resistance remains one of the main global health challenges, with the World Health Organization identifying it as a significant threat to public health. Children are particularly vulnerable, both as frequent recipients of antibiotics and as victims of the consequences of antimicrobial resistance. Factors such as parental expectations, diagnostic uncertainties, and systemic prescribing habits contribute to the overuse and misuse of antibiotics in pediatric populations.

This Special Issue of Children will explore the multifaceted aspects of antibiotic prescription and stewardship in pediatrics. We invite submissions of original research, quality improvement initiatives, implementation studies, health economics and outcome research (HEOR), and health outcome research that explore antibiotic use across various diseases, healthcare settings, and geographic regions. Submissions that delve into patient and family perspectives, educational strategies for learners, the integration of stewardship into clinical practice guidelines, the use of machine learning/artificial intelligence, and approaches to non-hospital-based practices are particularly encouraged.

Our goal is to foster a comprehensive understanding of current practices and to share innovative strategies that promote judicious antibiotic use among children. By bringing together diverse insights and experiences, this Special Issue will inform and inspire clinicians, public health officials, educators, and policymakers in their efforts to combat antibiotic resistance and enhance pediatric care.

Dr. Amanda G. Montalbano
Guest Editor

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Keywords

  • antimicrobial stewardship
  • anti-bacterial agents
  • drug prescriptions
  • drug resistance
  • inappropriate prescribing
  • quality improvement
  • treatment outcome
  • health services research
  • diffusion of innovation
  • translational medical research
  • ambulatory care
  • community health services
  • practice guidelines
  • evidence-based practice
  • health knowledge, attitudes, practice
  • patient education
  • pediatrics
  • child
  • parents
  • infant

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Published Papers (1 paper)

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Research

13 pages, 606 KB  
Article
Nurse-Initiated Improvement for Documentation of Penicillin Adverse Drug Reactions in Pediatric Urgent Care Clinics
by Elizabeth Monsees, Diane Petrie, Rana E. El Feghaly, Sarah Suppes, Brian R. Lee, Megan Whitt and Amanda Nedved
Children 2025, 12(8), 1087; https://doi.org/10.3390/children12081087 - 19 Aug 2025
Viewed by 430
Abstract
Background/Objective: Penicillin allergy labels (PALs) contribute to broad-spectrum antibiotic use. Thorough documentation can help prescribers identify and remove unnecessary PALs. We aimed to improve documentation of PALs in three pediatric urgent care (PUC) clinics, using a nurse-initiated quality improvement (QI) approach. Methods: QI [...] Read more.
Background/Objective: Penicillin allergy labels (PALs) contribute to broad-spectrum antibiotic use. Thorough documentation can help prescribers identify and remove unnecessary PALs. We aimed to improve documentation of PALs in three pediatric urgent care (PUC) clinics, using a nurse-initiated quality improvement (QI) approach. Methods: QI interventions included a survey to assess prescriber and nurse confidence, an online educational module, and an algorithm to aid in clarifying PALs. We measured the percentage of PALs with a clarified reaction severity as our primary outcome using annotated control charts. Descriptive and inferential statistics evaluated survey responses between nurses and prescribers. Results: Clarified PAL reaction severity had a sustained upward shift from 58.5% to 63.3% following implementation of our interventions. Of 129 nurses and prescribers, 87 (67.4%) respondents completed the survey. Prescribers and nurses reported feeling knowledgeable about PALs but experienced different challenges to clarifying PAL documentation. Prescribers reported time pressures as a barrier to PAL clarification more often than nurses (IQR [3, 4], p = 0.001). Nurses reported higher confidence in ability to document a PAL compared to prescribers (IQR [3.25, 5], p = 0.010). Respondents requested family education and practice guidance to aid PAL clarification. No consistent differences were noted in PAL documentation by sociodemographic characteristics. Conclusions: The nurse-initiated QI approach demonstrated improved PAL documentation in PUCs. Engaging nurses in antibiotic stewardship initiatives can provide new perspectives and broaden the approach to intervention design and implementation. Future efforts should focus on improving electronic health record and interprofessional workflow processes to build on these improvements. Full article
(This article belongs to the Special Issue Antibiotic Prescribing Practices and Stewardship in Pediatrics)
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