A simple, multifaceted antibiotic stewardship programme significantly improves adherence to guidelines for treating non-severe community-acquired pneumonia in children, a quasi-experimental before and after study conducted at Nantes University Hospital has demonstrated.
Electronic health record screening using predefined keywords identified 519 children between birth and 15 years and three months of age for inclusion in the study.
Following individual case review against eligibility criteria, 134 children (25.8%) with community-acquired pneumonia were included: 71 in the pre-intervention group and 63 in the post-intervention group.
Antibiotic stewardship intervention improved prescribing behaviour
The antibiotic stewardship programme intervention, which included prescriber training, guideline dissemination and case vignettes, led to a rise in guideline-concordant antibiotic duration (five days amoxicillin) from 38.0% to 79.4% (p < 0.0001).
The average course length dropped from 7.3 to 5.7 days, aligning with recommendations from the French Infectious Diseases Society, and avoided 155 antibiotic treatment days per 100 treated children.
Furthermore, correct amoxicillin dosing (±10% of the recommended dose) increased from 66% to 84% post-intervention (p = 0.03). Nasopharyngeal polymerase chain reaction testing became more frequent (61.9% vs 14.1%; p < 0.0001), possibly driven by practice changes during and after Covid-19.
Notably, no child returned for re-consultation within seven days of the end of the prescribed antibiotics as part of the antibiotic stewardship programme.
Limitation and lessons for wider implementation
The researchers noted limitations such as the single-centre, retrospective design and relatively small sample size, which may affect generalisability. The study did not assess prescribing rationale in depth or control for confounding influences such as seasonality or the Covid-19 pandemic.
Future work should evaluate long-term sustainability of the antibiotic stewardship programme and replicate findings across diverse clinical settings, they noted.
Despite these limitations, the researchers considered the findings promising for replication in other paediatric or primary care settings.
The intervention’s low cost and ease of implementation make it a pragmatic model for reducing antimicrobial resistance through targeted prescribing, they added.
Reference
Martin Perceval L et al. Implementing an antibiotic stewardship program to reduce the duration of antibiotics in community-acquired pneumonia: Experience in a French pediatric hospital. Arch Pédiatr. 2025;32:217–222.
