Antimicrobial Stewardship

ANZPID Australasian Stewardship of Antimicrobials in Paediatrics (ASAP)

The ANZPID-ASAP group was convened in mid 2011. The aims are:

  • To act as a focus group to promote antimicrobial stewardship in children in Australia and New Zealand via leadership and the exchange of information and ideas
  • To work towards a national antimicrobial stewardship program in children and advise on how this can best be achieved
  • To advocate that children be included in future plans regarding national antimicrobial stewardship


Please contact Penelope Bryant (Chair) for further information.


ASAP Group Terms of Reference



ASAP Guidelines for Antibiotic Duration and IV-Oral Switch

Launched on 17th June 2016

A large collaborative effort has resulted in the ANZPID-ASAP Guidelines for Antibiotic Duration and IV to Oral Switch in Children, the first guideline of its kind to provide recommendations for common bacterial infections in children. It is being launched to coincide with publication of the systematic review in The Lancet Infectious Diseases on 17th June 2016.

Go here (guideline page) for the link to the open access review in The Lancet ID and the guideline in different formats for ease of use.



Current Projects

International antimicrobial point prevalence survey and antimicrobial resistance in children

Our first project involved participation in an international antibiotic point prevalence study, established in Europe and rolled out worldwide – the ARPEC study (Antibiotic Resistance and Prescribing in European Children). ANZPID-ASAP added questions that we decided were important regarding appropriateness to better understand prescribing practices around Australia.

This has evolved into GARPEC (Global ARPEC), of which Penelope Bryant is an original member, an international collaboration which now seeks expand the participation of resource-poor countries and to add a survey of antimicrobial resistance in bloodstream infections.

Publications

Osowicki J, Gwee A, Noronha J, Palasanthiran P, McMullan B, Britton PN, Isaacs D, Lai T, Nourse C, Avent M, Moriarty P, Clark J, Francis JR, Blyth CC, Cooper CM, Bryant PA, on behalf of the ANZPID-ASAP group. Australia-wide point prevalence survey on the use and appropriateness of antimicrobial prescribing in children. Med J Australia 2014 Dec 11;201(11):657-62.

Osowicki J, Gwee A, Noronha J, Palasanthiran P, McMullan B, Britton PN, Isaacs D, Lai T, Nourse C, Avent M, Moriarty P, Clark J, Francis JR, Blyth CC, Cooper CM, Bryant PA, on behalf of the ANZPID-ASAP group. The Impact of an Infectious Diseases Consultation on Antimicrobial Prescribing. Pediatr Inf Dis J 2014 June; 33(6):669-71.

Osowicki J, Gwee A, Noronha J, Palasanthiran P, McMullan B, Britton PN, Isaacs D, Lai T, Nourse C, Avent M, Moriarty P, Clark J, Francis JR, Blyth CC, Cooper CM, Bryant PA, on behalf of the ANZPID-ASAP group. Australia-wide point prevalence survey of antibiotic prescribing in neonatal patients in tertiary hospitals: how much and how good? Pediatr Inf Dis J 2015 Aug;34(8):e185-90.

Conference presentations

Australian Society for Antimicrobials ASM, Adelaide 2013; World Society of Paediatric Infectious Diseases Congress, Cape Town 2013; ASID ASM, Adelaide 2014

Media

ABC 7.30 Report: Inappropriate antibiotic prescribing for children in hospitals.



Guidelines for antibiotic duration and iv to oral switch

We recognised the gap in the literature, so after initiation by David Andresen, Brendan McMullan led the drafting of an evidence-based guideline for duration of antibiotic treatment and intravenous to oral step down for a variety of bacterial infections in children. This led to a major systematic review of 36 infectious diseases. The majority of the group members took on one or two infections, reviewing the literature and writing evidence-based guidelines. These were then circulated to the wider group for comment. The final product resulted from a large group collaborative effort and provides for the first time evidence-based recommendations for common bacterial infections in one place.

Publication

McMullan B, Andresen D, Blyth CC, Avent M, Bowen A, Britton PN, Clark J, Cooper CM, Curtis N, Goeman E, Hazelton B, Haeusler GM, Khatami A, Newcombe J, Osowicki J, Palasanthiran P, Starr M, Lai T, Nourse C, Francis JR, Isaacs D, Bryant PA, on behalf of the ANZPID-ASAP group. Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. The Lancet Infectious Diseases 2016 June.



Antimicrobial stewardship resources in Australasian children

We surveyed the AMS resources and activities of tertiary hospitals that have children in Australia and New Zealand in June 2013. Group members and other paediatric ID physicians completed the survey and the findings were woeful. Most tellingly, there was only 0.1 EFT of paediatric ID physician time funded in a secure ongoing way across all hospitals in both countries. Only 4 out of the 14 hospitals had ongoing funding for a paediatric AMS pharmacist.

We are now in the process of repeating this survey 1) to assess the changes since the introduction of the AMS National Standards and 2) to include all hospitals that admit children nationally.

Publications

Bryant PA, on behalf of the ANZPID-ASAP group. Antimicrobial stewardship resources and activities for children in hospitals in Australasia: a comprehensive survey. Med J Australia 2015 Feb 16;202(3):134-8

Conference presentations

ASID ASM, Adelaide 2014



Antimicrobial Stewardship Resources

Australian Commission on Safety and Quality in Healthcare Antimicrobial Stewardship publication 2011

Infectious Diseases Society of America Antimicrobial Stewardship guideline 2007

National Institute for Clinical Excellence UK Antimicrobial stewardship: systems and processes 2015

National Safety and Quality Health Service (NSQHS) Standards: Standard 3 Healthcare Associated Infections


Meeting Minutes