Project Information

Prospective surveillance study of antimicrobial utilization in hospitalized children

Project Description: Increasing levels of antimicrobial resistance are a growing threat in the pediatric population. Fewer new antimicrobial drugs to market in the past two decades has limited the medications available to treat these resistant pathogens. Broad-spectrum antibiotics, such as carbapenems, are increasingly utilized due to emergence of multidrug resistant (MDR) bacteria in hospitalized children. Utilization of these agents empirically due to the suspected presence of an infection from an MDR bacteria has also increased. In clinical scenarios where no pathogen is identified, it is often challenging to determine the appropriate antimicrobial choice and duration of therapy required. Optimization of antimicrobial use in the acute care hospital setting through Antimicrobial Stewardship can assist in these scenarios and represents a key component of multifaceted strategies to slow the emergence of antimicrobial resistance Available data in adult patients suggest that nearly 2/3rd of antimicrobials used in the acute care hospital setting are either prophylactic or empirical in indication. There are limited data, however, on how antimicrobials are currently used in hospitalized children to guide interventions to optimize use. Antimicrobial utilization at UF Health Shands Children’s Hospital has not been systematically reviewed previously to determine local use patterns. We propose a quality improvement project focusing on identifying 1) antimicrobial utilization rates at UF Health Shands Children’s Hospital prospectively, 2) clinical indications for antimicrobial utilization, and 3) clinical scenarios in which broad-spectrum antimicrobial agents are used empirically beyond 72 hours. Results of this QI project will be used by the hospital’s Antimicrobial Stewardship Program to formulate guidelines for appropriate antimicrobial utilization across units. Results will also be applied towards a multicenter pediatric healthcare institution quality improvement collaboration, Solutions for Patient Safety.

QPI: Matthew, Washam, (


Advisors: Matthew, Washam, (

UF Health Big Aims: Zero Harm None

MeSH Keywords: multidrug resistance, antimicrobial stewardship