It’s that time of year again! Antibiotic Awareness Week 2021 is recognized November 18 through November 24.
What is Antibiotic Awareness Week?
Antibiotic Awareness Week is an annual observance to raise awareness of antibiotic resistance and the importance of appropriate antibiotic use.
What is antibiotic stewardship?
Antibiotics are one of the most radically transformative medical discoveries of the last century. They are a potent tool at our disposal. Antibiotic stewardship focuses on ensuring that when antibiotics are used, they meet the following goals:
- The Right Drug
- Given at the Right Dose
- To the Right Patient
- For the Right Diagnosis
- And for the Right Duration
Our goal is to help the treating provider choose the best treatment for their patient, like an antibiotic sommelier.
Why are those things important?
While antibiotics are typically well tolerated in children, no medication is entirely without side effects. It’s important to ensure that the patient has a condition that an antibiotic will treat; otherwise, we would be exposing patients to potentially harmful side effects without expectation of benefit. Common side effects associated with antibiotics include stomachache, diarrhea, kidney or liver injury, and rash. It can even lead to severe infections like Clostridioides difficile colitis.
Additionally, viral infections often cause rashes and are the most common cause of hives in childhood. If a child is inappropriately prescribed an antibiotic for a viral infection and develops hives, the likely outcome is that the antibiotic will be listed as an allergy in that child’s chart. The most commonly prescribed antibiotic to children in the outpatient setting is amoxicillin, which belongs to the class of antibiotics called beta-lactams. Patients with a beta-lactam allergy in their chart are more than three times more likely to have an adverse medication event in the hospital than patients who are not labelled allergic. Penicillin de-labeling efforts have shown that roughly 1% of children labelled with a penicillin/amoxicillin allergy truly have an allergy.
Lastly, no antibiotic will be entirely effective forever (at least so far). Bacterial resistance to a new antibiotic usually emerges within the first decade after the drug is developed. By making sure we are using antibiotics targeted to the patient’s infection, rather than a broader drug, we can ensure that those drugs remain effective for as long as possible.
What does it mean to be Antibiotics Aware?
For parents: it means understanding that antibiotics are only useful if your child has a bacterial infection. If they have a virus like the common cold, the antibiotic is likely to give your child diarrhea and will not provide any benefit. But even if antibiotics won’t help, your pediatrician can give you recommendations to help your child feel better!
For medical providers: It means only using antibiotics when there is a reasonable suspicion for a bacterial infection, explaining the risks of using antibiotics when there is not a clear indication, and recommending common supportive therapies (possibly combined with a delayed prescribing strategy if the diagnosis is unclear).
Delayed prescribing means giving a prescription (for example, for an ear infection in an older child) and telling the parent to only pick up the prescription if the child does not improve in the next 24-48 hours.
About the Authors
Dr. Danièle Gusland joined Valley Children’s as an infectious disease specialist in 2020. A fellow of the American Academy of Pediatrics, Dr. Gusland’s research interests include antimicrobial stewardship and global health. She is the medical director of Valley Children’s Antimicrobial Stewardship Program, which aims to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, which reduces healthcare costs without impacting quality of care.
Brenik Kuzmic, PharmD earned his Antimicrobial Stewardship Certificate from the Society of Infectious Diseases Pharmacists and is the pharmacy lead for Valley Children’s Antimicrobial Stewardship Program (ASP). With the ASP, he worked to help Valley Children’s become an Antimicrobial Stewardship Center of Excellence as designated by the Infectious Disease Society of America.