Results of previous studies have indicated that most antibiotic prescriptions for children are for respiratory conditions, and many of them are inappropriate. Although antibiotic prescribing is declining overall, broad-spectrum antibiotic prescribing for respiratory conditions is increasing. Unnecessary antibiotic prescribing promotes resistance and adverse events.

Respiratory conditions account for >70% of antibiotic prescriptions in ambulatory pediatrics. Broad-spectrum antibiotics, especially macrolides, represent 50% of pediatric antibiotic use. Broad-spectrum antibiotics are frequently prescribed unnecessarily for conditions for which antibiotics are unlikely to provide benefit.

Few children's hospitals have implemented comprehensive antimicrobial stewardship programs (ASPs). Beyond reporting proportions of children who received antimicrobials during their hospitalization, complete data about the extent of antimicrobial use in pediatric hospitals before and after ASP implementation do not currently exist.

Since introducing an ASP in 2004, its effect on antimicrobial use, interventions, outcomes, and rates of antimicrobial resistance has been prospectively evaluated. This publication thoroughly describes the impact...

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